Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05794 | Date 16/07/2019 |
| Token No | SM/19-20/6567 16/07/2019 | Serial | 015 Last Visit: 16/07/2019 |
| Patient Name | Mr. SUNIL ROY | Contact No | 8013312303 |
| Address | 159 CHARABAGAN BARUIPARA,BAIDYABATI(M) | Age | 59 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||