Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06298 | Date 31/08/2019 |
| Token No | SM/19-20/9604 31/08/2019 | Serial | 085 Last Visit: 31/08/2019 |
| Patient Name | Mr. KESHAB CHANDRA DAS | Contact No | 9748550064 |
| Address | 5 SIDDESWARI LANE CHATRA SERAMPORE | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||