Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05800 | Date 16/07/2019 |
| Token No | SM/19-20/6619 16/07/2019 | Serial | 067 Last Visit: 23/07/2019 |
| Patient Name | Mr. TAPAN BERA | Contact No | 9088285586 |
| Address | 109/C CHATRA TELI PARA,BAIDYABATI(M) | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||