Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07192 | Date 19/12/2019 |
| Token No | SM/19-20/15621 19/12/2019 | Serial | 050 Last Visit: 19/12/2019 |
| Patient Name | Mr. SANTU NASKAR | Contact No | 9836458184 |
| Address | 23/C G T ROAD GODAR BAGAN BYE LANE CHATRA , BAIDYABATI(M) | Age | 33 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||