Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03280 | Date 01/02/2019 |
| Token No | SM/18-19/7763 01/02/2019 | Serial | 039 Last Visit: 01/02/2019 |
| Patient Name | Mr. SUBHA DEY | Contact No | 9674123299 |
| Address | 47/1 G T ROAD,TETUL TALA,BAIDYABATY(M) | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||