Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06196 | Date 21/08/2019 |
| Token No | SM/19-20/8933 21/08/2019 | Serial | 095 Last Visit: 21/08/2019 |
| Patient Name | Mr. SAMIM ANSARI | Contact No | 7685001718 |
| Address | G T ROAD PAMPANAGAR , BAIDYABATI(M) | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||