Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03992 | Date 05/03/2019 |
| Token No | SM/18-19/9829 05/03/2019 | Serial | 030 Last Visit: 05/03/2019 |
| Patient Name | Mr. NIRMAL DEBNATH | Contact No | 9804179680 |
| Address | CHATRA BAGER BAGAN, BAIDYABATI (M) | Age | 63 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||