Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05795 | Date 16/07/2019 |
| Token No | SM/19-20/6571 16/07/2019 | Serial | 019 Last Visit: 16/07/2019 |
| Patient Name | Mr. BRINDABAN DHARA | Contact No | |
| Address | MOLLASIMLA,HOOGHLY49 | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||