Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05634 | Date 02/07/2019 |
| Token No | SM/19-20/10438 16/09/2019 | Serial | 039 Last Visit: 14/12/2020 |
| Patient Name | Mr. DIBYENDU MANNA | Contact No | 9038717822 |
| Address | 171 G.T ROAD W TANK, BAIDYABATI(M) | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||