Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04282 | Date 18/03/2019 |
| Token No | SM/18-19/10831 19/03/2019 | Serial | 024 Last Visit: 19/03/2019 |
| Patient Name | Mr. DIPAK SAHA | Contact No | 8443826413 |
| Address | 118 G.T ROAD CHATRA , BAIDYABATI(M) | Age | 31 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 85 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||