Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06105 | Date 10/08/2019 |
| Token No | SM/19-20/8313 10/08/2019 | Serial | 034 Last Visit: 10/08/2019 |
| Patient Name | Mr. PANKAJ KUMAR DAS | Contact No | 7003427542 |
| Address | 120A TELIPARA CHATRA , BAIDYABATI(M) | Age | 44 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||