Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04590 | Date 06/04/2019 |
| Token No | SM/19-20/402 06/04/2019 | Serial | 030 Last Visit: 06/04/2019 |
| Patient Name | Mr. MD MAGID KHAN | Contact No | 9062095968 |
| Address | 57/G/C/C G.T ROAD PAMPA NAGAR, BAIDYABATI(M) | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||