Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06736 | Date 22/10/2019 |
| Token No | SM/19-20/12253 22/10/2019 | Serial | 076 Last Visit: 22/10/2019 |
| Patient Name | Mr. GOUTAM PAL | Contact No | 7044148123 |
| Address | 113 CHATRA TELI BAGER BAGAN , BAIDYABATI(M) | Age | 59 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||