Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02796 | Date 03/01/2019 |
| Token No | SM/19-20/22478 27/05/2020 | Serial | 020 Last Visit: 27/05/2020 |
| Patient Name | Mr. SISIR DAS | Contact No | 9874765270 |
| Address | 18/D BEBEKANANDA LANE | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||