Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03659 | Date 18/02/2019 |
| Token No | SM/19-20/12158 21/10/2019 | Serial | 055 Last Visit: 14/03/2020 |
| Patient Name | Mr. KANHIYA RAUTH | Contact No | 9883240077 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI (M) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||