Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 08452 | Date 29/06/2020 |
| Token No | SM/19-20/24268 20/07/2020 | Serial | 041 Last Visit: 02/08/2021 |
| Patient Name | Mr. RAMCHANDRA DAS | Contact No | 9681412099 |
| Address | 38, NABIN CHANDRA CHAKRABORTY LANE, BAIDYABATI(M) | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||