Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05516 | Date 22/06/2019 |
| Token No | SM/19-20/5049 22/06/2019 | Serial | 010 Last Visit: 22/06/2019 |
| Patient Name | Mr. UPEN THAKUR | Contact No | 9051765385 |
| Address | BAGER BAGAN CHATRA , BAIDYABATI(M) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||