Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06892 | Date 18/11/2019 |
| Token No | SM/19-20/21929 05/05/2020 | Serial | 010 Last Visit: 05/05/2020 |
| Patient Name | Mr. SHAMBHU GHORUI | Contact No | 8420979068 |
| Address | 50, G.T ROAD CHATRA , BAIDYABATI(M) | Age | 49 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||