Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04505 | Date 02/04/2019 |
| Token No | SM/19-20/66 02/04/2019 | Serial | 004 Last Visit: 02/04/2019 |
| Patient Name | Mr. GOPI NATH MONDAL | Contact No | 9830242686 |
| Address | 59 G. T ROAD CHATRA TETULTALA , BAIDYABATI(M) | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 90/70 mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||