Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06538 | Date 25/09/2019 |
| Token No | SM/19-20/11079 25/09/2019 | Serial | 021 Last Visit: 25/09/2019 |
| Patient Name | Mr. DEBAYAN DHARA | Contact No | 7980048925 |
| Address | 28 DR. BAGAN LANE | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||