Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08545 | Date 15/07/2020 |
| Token No | SM/19-20/24139 15/07/2020 | Serial | 015 Last Visit: 15/07/2020 |
| Patient Name | Mr. GOUTAM DAS | Contact No | 9883607223 |
| Address | 8 TELIPARA LANE CHATRA , BAIDYABATI(M) | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||