Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04416 | Date 27/03/2019 |
| Token No | SM/18-19/11320 27/03/2019 | Serial | 024 Last Visit: 01/04/2020 |
| Patient Name | Mr. JAYDEB DAS | Contact No | 7044244408 |
| Address | CHATRA GT ROAD MANIK GHOSER BAGAN , BAIDYABATI(M) | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||