Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01496 | Date 04/10/2018 |
| Token No | SM/18-19/5240 14/12/2018 | Serial | 029 Last Visit: 15/06/2020 |
| Patient Name | Mr. SOURAV MONDAL | Contact No | 8013332298 |
| Address | 154, CAHTRA TELI PARA BAGER BAGAN, BAIDYABATI(M) | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||