Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06836 | Date 11/11/2019 |
| Token No | SM/19-20/13043 11/11/2019 | Serial | 085 Last Visit: 21/11/2019 |
| Patient Name | Mr. LAKHI DAS | Contact No | 7044008185 |
| Address | 243/89/1 TELIPARA LANE G T ROAD , BAIDYABTI(M) | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||