Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05854 | Date 19/07/2019 |
| Token No | SM/19-20/6881 19/07/2019 | Serial | 071 Last Visit: 19/07/2019 |
| Patient Name | Mr. SHYAM BELEL | Contact No | 9088288033 |
| Address | 51/1/A SATCHASI PARA,BAIDYABATI(M) | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||