Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05689 | Date 06/07/2019 |
| Token No | SM/19-20/6012 06/07/2019 | Serial | 075 Last Visit: 06/07/2019 |
| Patient Name | Mr. SAMBHU ROY | Contact No | 8337073841 |
| Address | 24,MUSALMAN PARA LANE | Age | 58 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||