Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05252 | Date 27/05/2019 |
| Token No | SM/19-20/3506 27/05/2019 | Serial | 062 Last Visit: 27/05/2019 |
| Patient Name | Mr. NIRANJAN DAS | Contact No | 7998311653 |
| Address | 29/F CHATRA GODAR BAGAN GT ROAD , BAIDYABATI(M) | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||