Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06590 | Date 30/09/2019 |
| Token No | SM/19-20/11763 15/10/2019 | Serial | 041 Last Visit: 30/06/2021 |
| Patient Name | Mr. GUPI NATH KAIRI | Contact No | 9836710132 |
| Address | G T ROAD ,PAMPA NAGAR,BAIDYABATI(M) | Age | 64 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||