Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05920 | Date 24/07/2019 |
| Token No | SM/19-20/7188 24/07/2019 | Serial | 030 Last Visit: 24/07/2019 |
| Patient Name | Mr. SADHIN DAS | Contact No | 9674416198 |
| Address | 73/2/2 G T ROAD CHATRA SHITLATALA JAL TANK , BAIDYABATI(M) | Age | 58 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||