Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04968 | Date 29/04/2019 |
| Token No | SM/19-20/1882 29/04/2019 | Serial | 038 Last Visit: 29/04/2019 |
| Patient Name | Mr. TARAKESWAR RAJBANSHI | Contact No | 9038304268 |
| Address | 10/A/Z/Z/E G.T ROAD CHATRA MARADAN, BAIDYABATI (M) | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 72 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||