Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08091 | Date 16/04/2020 |
| Token No | SM/19-20/21195 16/04/2020 | Serial | 037 Last Visit: 16/04/2020 |
| Patient Name | Mr. NIRMAL DAS | Contact No | |
| Address | 10/A/Z E POMPA NAGAR,BAIDYABATI(M) | Age | 66 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||