Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05011 | Date 03/05/2019 |
| Token No | SM/19-20/14473 02/12/2019 | Serial | 066 Last Visit: 02/12/2019 |
| Patient Name | Mr. DIPANKAR KAYAL | Contact No | 9163402845 |
| Address | CHATRA BAGER BAGAN , BAIDYABATI(M) | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||