Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04695 | Date 13/04/2019 |
| Token No | SM/19-20/7772 02/08/2019 | Serial | 004 Last Visit: 12/10/2019 |
| Patient Name | Mr. AMIT RAY | Contact No | 7688016516 |
| Address | CHARA BAGAN BAURI PARA, BAIDYABATI(M) | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||