Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08394 | Date 20/06/2020 |
| Token No | SM/19-20/23262 20/06/2020 | Serial | 001 Last Visit: 20/06/2020 |
| Patient Name | Mr. SAMIR DUTTA | Contact No | 6254879456 |
| Address | RAMKRISHNA ROAD HARISABHA , BAIDYABATI(M) | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||