Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05743 | Date 13/07/2019 |
| Token No | SM/19-20/6341 13/07/2019 | Serial | 005 Last Visit: 18/07/2019 |
| Patient Name | Mr. NEPAL DAS | Contact No | 8420845558 |
| Address | 52 SATCHASI PARA,BAIDYABATI(M) | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||