Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07833 | Date 18/03/2020 |
| Token No | SM/19-20/20732 04/04/2020 | Serial | 013 Last Visit: 16/04/2020 |
| Patient Name | Mr. UTTAM DAS | Contact No | 8013074369 |
| Address | 95(78/3/C/N) TELIPARA BAGHER BAGAN,BAIDYABATI(M) | Age | 49 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||