Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04921 | Date 26/04/2019 |
| Token No | SM/19-20/1710 26/04/2019 | Serial | 022 Last Visit: 29/04/2019 |
| Patient Name | Mr. AMIT CHAKRABORTY | Contact No | 9062750261 |
| Address | PAMPA NAGAR , BAIDYABATI(M) | Age | 29 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||