Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04502 | Date 02/04/2019 |
| Token No | SM/19-20/63 02/04/2019 | Serial | 001 Last Visit: 02/04/2019 |
| Patient Name | Mr. HARU MONDAL | Contact No | 9830407211 |
| Address | 202 CHATRA KUMAR BAGAN ,BAIDYABATI(M) RATION CARD- PHH 0015755701 | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||