Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02142 | Date 26/11/2018 |
| Token No | SM/19-20/23010 12/06/2020 | Serial | 016 Last Visit: 12/03/2021 |
| Patient Name | Mr. SHASHTICHARAN DAS | Contact No | |
| Address | CHATRA GHOSH PARA | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||