Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04784 | Date 20/04/2019 |
| Token No | SM/19-20/1243 20/04/2019 | Serial | 064 Last Visit: 07/12/2019 |
| Patient Name | Mr. SARAP PAUL | Contact No | 6290698589 |
| Address | CHATRA BOU BAZAR GT ROAD , BAIDYABATI(M) | Age | 64 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||