Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07377 | Date 20/01/2020 |
| Token No | SM/19-20/16940 20/01/2020 | Serial | 053 Last Visit: 20/01/2020 |
| Patient Name | Mr. MANTU BURMAN | Contact No | 9163887832 |
| Address | CHATRA BAGER BAGAN , BAIDYABATI(M) | Age | 46 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||