Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04994 | Date 02/05/2019 |
| Token No | SM/19-20/2060 02/05/2019 | Serial | 031 Last Visit: 02/05/2019 |
| Patient Name | Mr. SUBHOJIT DALAL | Contact No | 7439307805 |
| Address | 192/75 CHATRA TELI PARA BAGER BAGAN , BAIDYABATI(M) | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||