Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06109 | Date 10/08/2019 |
| Token No | SM/19-20/8331 10/08/2019 | Serial | 052 Last Visit: 10/08/2019 |
| Patient Name | Mr. ANTIM DAS | Contact No | 9051799377 |
| Address | RAJDHARPUR BHATTCHARJEE GARDEN ,BISHWAKABI PARA | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||