Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06959 | Date 22/11/2019 |
| Token No | SM/19-20/13800 22/11/2019 | Serial | 049 Last Visit: 22/11/2019 |
| Patient Name | Mr. MADHU DAS | Contact No | 9038588769 |
| Address | 68/N G.T ROAD WEST SERAMPORE MALLICK PARA | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||