Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05073 | Date 11/05/2019 |
| Token No | SM/19-20/2579 11/05/2019 | Serial | 067 Last Visit: 11/05/2019 |
| Patient Name | Mr. GOPAL HALDAR | Contact No | 9674039044 |
| Address | BAGER BAGAN, BAIDYABATI M | Age | 32 Y Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||