Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03103 | Date 21/01/2019 |
| Token No | SM/18-19/10736 18/03/2019 | Serial | 035 Last Visit: 05/02/2020 |
| Patient Name | Mr. MUKTI PADA DAS | Contact No | 9874948184 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI (M) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||