Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03732 | Date 20/02/2019 |
| Token No | SM/18-19/9121 20/02/2019 | Serial | 059 Last Visit: 20/02/2019 |
| Patient Name | Mr. SHUVO HAPOR | Contact No | 8478098850 |
| Address | CHATRA BAGER BAGAN, BAIDYABTI(M) | Age | 20 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||