Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04711 | Date 16/04/2019 |
| Token No | SM/19-20/946 16/04/2019 | Serial | 062 Last Visit: 16/04/2019 |
| Patient Name | Mr. MURARI PAL | Contact No | 9239430700 |
| Address | CHATRA SHITLATA TETUL TALA BAJAR, BAIDYABATI(M) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||