Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05683 | Date 06/07/2019 |
| Token No | SM/19-20/6095 08/07/2019 | Serial | 068 Last Visit: 18/07/2019 |
| Patient Name | Mr. NETAI CH DAS | Contact No | 9051355634 |
| Address | 88 GOILA PARA LANE , BAIDYABATI(M) | Age | 70 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||