Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03577 | Date 14/02/2019 |
| Token No | SM/18-19/8678 14/02/2019 | Serial | 043 Last Visit: 17/07/2019 |
| Patient Name | Mr. BIMAL FUSTI | Contact No | 8936373688 |
| Address | CHATRA BOUBAZAR,BAIDYABATI(M) | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||