Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07428 | Date 27/01/2020 |
| Token No | SM/19-20/17267 27/01/2020 | Serial | 062 Last Visit: 27/01/2020 |
| Patient Name | Mr. SHYAMAL FUSTY | Contact No | |
| Address | 22/2 TELI PARA CHATRA , BAIDYABATI(M) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||