Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05765 | Date 13/07/2019 |
| Token No | SM/19-20/6448 13/07/2019 | Serial | 112 Last Visit: 30/08/2019 |
| Patient Name | Mr. INDRANIL PAUL | Contact No | 8240901863 |
| Address | 269 D/A GHOSAL PARA LANE,BAIDYABAIT(IM) | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||