Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07025 | Date 30/11/2019 |
| Token No | SM/19-20/20451 30/03/2020 | Serial | 002 Last Visit: 30/03/2020 |
| Patient Name | Mr. BISWAJIT HALDER | Contact No | 7003307056 |
| Address | 171/172 TELIPARA BAGER BAGAN CHATRA BAIDYABATI(M) | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||