Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02310 | Date 03/12/2018 |
| Token No | SM/19-20/1020 17/04/2019 | Serial | 027 Last Visit: 17/04/2019 |
| Patient Name | Mr. JAGONNATH ROY | Contact No | 9874782635 |
| Address | CHATRA BAGER BAGAN,BAIDYABATY(M) | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||