Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07044 | Date 02/12/2019 |
| Token No | SM/20-21/28079 04/12/2020 | Serial | 030 Last Visit: 07/11/2022 |
| Patient Name | Mr. GOPAL PAL | Contact No | 8910594026 |
| Address | 362 G.T ROAD CHATRA , BAIDYBATI(M) | Age | 79 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||