Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03890 | Date 27/02/2019 |
| Token No | SM/18-19/9527 27/02/2019 | Serial | 016 Last Visit: 27/02/2019 |
| Patient Name | Mr. PANCHUGOPAL CHOWDHURY | Contact No | 9875511897 |
| Address | 4 DR BAGAN LANE | Age | 32 yrs Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||