Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03689 | Date 19/02/2019 |
| Token No | SM/18-19/8985 19/02/2019 | Serial | 015 Last Visit: 19/02/2019 |
| Patient Name | Mr. SHYAMSUNDAR PAL | Contact No | |
| Address | CHATRA BOU BAJAR , BAIDYABATI(M) | Age | 80 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||