Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 06248 | Date 28/08/2019 |
| Token No | SM/19-20/9296 28/08/2019 | Serial | 019 Last Visit: 28/08/2019 |
| Patient Name | Mr. TARAK DAS | Contact No | 9874612605 |
| Address | BARUIPARA CHARABAGAN SHEORAPHULI , BAIDYABATI(M) | Age | 36 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 72 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||