Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05754 | Date 13/07/2019 |
| Token No | SM/19-20/6392 13/07/2019 | Serial | 056 Last Visit: 13/07/2019 |
| Patient Name | Mr. RAM CHANDRA RAM | Contact No | 9051464710 |
| Address | 23 CHHATUGUNJ,BAIDYABATI(M) | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||