Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06344 | Date 06/09/2019 |
| Token No | SM/19-20/9863 06/09/2019 | Serial | 028 Last Visit: 20/11/2019 |
| Patient Name | Mr. SHIB DAS | Contact No | 8981649795 |
| Address | 2 PASCHIM KHANPUKUR LANE ANGUS , BHADRESHWAR (M) | Age | 31 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||