Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05582 | Date 26/06/2019 |
| Token No | SM/19-20/6494 15/07/2019 | Serial | 037 Last Visit: 15/07/2019 |
| Patient Name | Mr. MAHESH GIRI | Contact No | 8017999361 |
| Address | 62/D GHOSAL PARA NABAGRAM BAIDYABATI(M) HOOGHLY MALLICKPARA | Age | 32 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||