Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04373 | Date 25/03/2019 |
| Token No | SM/19-20/17948 12/02/2020 | Serial | 058 Last Visit: 17/03/2020 |
| Patient Name | Mr. BAIDYANATH MALAKER | Contact No | 8420165811 |
| Address | 18 GD BHATTACHARYA LANE CHATRA , BAIDYABATI(M) | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||