Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06162 | Date 20/08/2019 |
| Token No | SM/19-20/8749 20/08/2019 | Serial | 028 Last Visit: 20/08/2019 |
| Patient Name | Mr. SHIBAPROSAD CHAKRABORTY | Contact No | 9339122048 |
| Address | 36 NABIN CH. CHAKRABORTY LANE CHATRA , BAIDYABATI(M) | Age | 64 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||