Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04492 | Date 01/04/2019 |
| Token No | SM/19-20/9 01/04/2019 | Serial | 009 Last Visit: 01/04/2019 |
| Patient Name | Mr. SHAMBHU NATH TEWARI | Contact No | 8961041521 |
| Address | SHEORAPHULI BARUI PARA , BAIDYABATI (M) | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||