Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07193 | Date 19/12/2019 |
| Token No | SM/19-20/15624 19/12/2019 | Serial | 053 Last Visit: 19/12/2019 |
| Patient Name | Mr. TAPAN BEHARA | Contact No | 9830485272 |
| Address | TELIPARA LANE CHATRA , BAIDYABATI(M) | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||