Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03047 | Date 17/01/2019 |
| Token No | SM/19-20/2490 10/05/2019 | Serial | 087 Last Visit: 24/12/2022 |
| Patient Name | Mr. SANKAR DAS | Contact No | 9681931323 |
| Address | CHATRA BAGER BAGAN, BAIDYABATI(M) | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||