Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00799 | Date 29/08/2018 |
| Token No | SM/18-19/10898 20/03/2019 | Serial | 003 Last Visit: 20/03/2019 |
| Patient Name | Mr. KALIPADA BISWAS | Contact No | 9874943517 |
| Address | CHATRA BAGHER BAGAN | Age | 83.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||