Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07153 | Date 14/12/2019 |
| Token No | SM/19-20/15336 14/12/2019 | Serial | 101 Last Visit: 15/10/2020 |
| Patient Name | Mr. AMBUJ SARKAR | Contact No | 8900097421 |
| Address | SHIBTOLA GOPALPUR | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||