Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04843 | Date 22/04/2019 |
| Token No | SM/19-20/6333 11/07/2019 | Serial | 083 Last Visit: 23/09/2020 |
| Patient Name | Mr. GAUTAM DAS | Contact No | 9874019243 |
| Address | 8B, BENIAPARA LANE | Age | 54 Y Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||