Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03736 | Date 20/02/2019 |
| Token No | SM/19-20/7270 25/07/2019 | Serial | 023 Last Visit: 25/07/2019 |
| Patient Name | Mr. SAYANTAN PAL | Contact No | 7687015267 |
| Address | CHATRA MANIK GHOSER BAGAN , BAIDYABATI(M) | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||