Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04698 | Date 13/04/2019 |
| Token No | SM/19-20/857 13/04/2019 | Serial | 017 Last Visit: 13/04/2019 |
| Patient Name | Mr. SUBRATA MODAK | Contact No | 6291894391 |
| Address | RAMKRISHNA NAGAR , BAIDYABATI(M) | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||