Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01934 | Date 12/11/2018 |
| Token No | SM/19-20/11602 12/10/2019 | Serial | 017 Last Visit: 17/04/2020 |
| Patient Name | Mr. GOURANGA MOHAN SIL | Contact No | 9531657295 |
| Address | 32/B DR. BAGAN LANE | Age | 57 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||