Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05451 | Date 15/06/2019 |
| Token No | SM/19-20/4666 15/06/2019 | Serial | 049 Last Visit: 17/06/2019 |
| Patient Name | Mr. ARDHENDU MUKHERJEE | Contact No | 9836865296 |
| Address | 31,N.C. GHOSH SARANI ,BAIDYABATI(M) MOHISTIKRI | Age | 39 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||