Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05788 | Date 15/07/2019 |
| Token No | SM/19-20/6542 15/07/2019 | Serial | 085 Last Visit: 15/07/2019 |
| Patient Name | Mr. BIMAL CHANDRA PAL | Contact No | 8981378272 |
| Address | 10/A KUMORPARA /LANE | Age | 57 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||