Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07876 | Date 21/03/2020 |
| Token No | SM/19-20/24065 13/07/2020 | Serial | 035 Last Visit: 17/08/2020 |
| Patient Name | Mr. SANTI SASMAL | Contact No | 6291770306 |
| Address | 40/B BHATTACHARJEE GARDEN BYE LANE , NABAGRAM, BAIDYABATI(M) | Age | 33 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||