Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05832 | Date 19/07/2019 |
| Token No | SM/19-20/6812 19/07/2019 | Serial | 002 Last Visit: 19/07/2019 |
| Patient Name | Mr. BISWAJIT PAL | Contact No | 9748283032 |
| Address | 71/1/A TELIPARA,GOYALAPARA LANE,BAIDYABATI(M) | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||