Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04887 | Date 24/04/2019 |
| Token No | SM/19-20/1560 24/04/2019 | Serial | 030 Last Visit: 24/04/2019 |
| Patient Name | Mr. SHITAL CHOWDHURY | Contact No | 8420160685 |
| Address | 182, DA, G.T ROAD MANIK GHOSH BAGAN , BAIDYABATI(M) | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||