Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01389 | Date 27/09/2018 |
| Token No | SM/18-19/2367 03/10/2018 | Serial | 022 Last Visit: 03/10/2018 |
| Patient Name | Mr. BINOD KUMAR RAJBHAR | Contact No | 8820164044 |
| Address | 4/D BARO BAGAN LANE | Age | 44 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||