Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04065 | Date 07/03/2019 |
| Token No | SM/18-19/10078 07/03/2019 | Serial | 081 Last Visit: 07/03/2019 |
| Patient Name | Mr. LALSA JAISAWAL | Contact No | |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||