Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02054 | Date 20/11/2018 |
| Token No | SM/21-22/7181 26/11/2021 | Serial | 002 Last Visit: 30/11/2021 |
| Patient Name | Mr. BIKASH MAJHI | Contact No | 8420282175 |
| Address | 16/A CHATRA GODAR BAGAN BY LANE , BAIDYABATI(M) | Age | 36 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||