Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02174 | Date 28/11/2018 |
| Token No | SM/18-19/6462 08/01/2019 | Serial | 016 Last Visit: 08/01/2019 |
| Patient Name | Mr. KANAI LAL MONDAL | Contact No | 8820487308 |
| Address | BAGER BAGAN , BAIDYABATI (M) | Age | 64 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||