Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08087 | Date 16/04/2020 |
| Token No | SM/19-20/21165 16/04/2020 | Serial | 007 Last Visit: 16/04/2020 |
| Patient Name | Mr. SUNIL ADHIKARY | Contact No | 9007109245 |
| Address | 400 RAJAR BAGAN ,G.T. ROAD,BAIDYABATI(M) | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||