Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02410 | Date 08/12/2018 |
| Token No | SM/19-20/6366 13/07/2019 | Serial | 030 Last Visit: 13/07/2019 |
| Patient Name | Mr. SANJAY BAIRAGI | Contact No | 8478898969 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||