Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05767 | Date 13/07/2019 |
| Token No | SM/19-20/6451 13/07/2019 | Serial | 115 Last Visit: 13/07/2019 |
| Patient Name | Mr. RATAN BELEL | Contact No | 9748022004 |
| Address | 117/57,LANKER BAGAN SATCHASI PARA,BAIDYATI(M) | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||