Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06684 | Date 18/10/2019 |
| Token No | SM/19-20/11999 18/10/2019 | Serial | 019 Last Visit: 18/10/2019 |
| Patient Name | Mr. SHYAMAL GHOSH | Contact No | 9674287939 |
| Address | 307 (117/8) G.T ROAD CHATRA , BAIDYABATI(M) | Age | 41 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||