Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06131 | Date 16/08/2019 |
| Token No | SM/19-20/8519 16/08/2019 | Serial | 102 Last Visit: 16/08/2019 |
| Patient Name | Mr. MAHADEBRUI DAS | Contact No | 9674066642 |
| Address | 36/4/ HARIJAN ROAD , BAIDYABATI(M) | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||