Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04564 | Date 05/04/2019 |
| Token No | SM/19-20/3685 29/05/2019 | Serial | 052 Last Visit: 29/05/2019 |
| Patient Name | Mr. SANJIT MONDAL | Contact No | 9051834575 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 20 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||