Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04093 | Date 08/03/2019 |
| Token No | SM/18-19/10990 20/03/2019 | Serial | 095 Last Visit: 20/03/2019 |
| Patient Name | Mr. BHOMBAL PARAMANIK | Contact No | 8820645899 |
| Address | GOYALAPARA,SEORAPHULI BAIDYABATI(M) | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||