Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07191 | Date 19/12/2019 |
| Token No | SM/19-20/15620 19/12/2019 | Serial | 049 Last Visit: 19/12/2019 |
| Patient Name | Mr. KARTIK DOLUI | Contact No | |
| Address | TELIPARA BAGER BAGAN CHATRA , BAIDYABATI(M) | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||