Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04433 | Date 28/03/2019 |
| Token No | SM/18-19/11404 28/03/2019 | Serial | 006 Last Visit: 01/08/2019 |
| Patient Name | Mr. ATANA KUNDU | Contact No | 9830473837 |
| Address | 24/2/A GOYALA PARA PARA BOWBAZAR CHATRA , BAIDYABATI(M) | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||