Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02246 | Date 30/11/2018 |
| Token No | SM/18-19/4455 30/11/2018 | Serial | 044 Last Visit: 18/03/2019 |
| Patient Name | Mr. PRADIP DAS | Contact No | 8017894602 |
| Address | CHATRA BAGER BAGAN ,TELI PARA,BAIDYABATY(M) | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||