Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06160 | Date 20/08/2019 |
| Token No | SM/19-20/8733 20/08/2019 | Serial | 012 Last Visit: 20/08/2019 |
| Patient Name | Mr. SUKANTA KOLEY | Contact No | 8013608703 |
| Address | 96 RAMKRISHANA ROAD , BAIDYABATI(M) | Age | 32 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 77 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||