Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04435 | Date 28/03/2019 |
| Token No | SM/18-19/11410 28/03/2019 | Serial | 012 Last Visit: 28/03/2019 |
| Patient Name | Mr. NISIT BISWAS | Contact No | 8336015051 |
| Address | CHATRA LANKAR BAGAN , BAIDYABATI(M) | Age | 39 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||