Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02629 | Date 21/12/2018 |
| Token No | SM/18-19/5573 21/12/2018 | Serial | 023 Last Visit: 05/04/2019 |
| Patient Name | Mr. ANIL ROY | Contact No | |
| Address | CHATRA BAGHER BAGAN ,TELIPARA,BAIDYABATI(M) | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||