Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08770 | Date 22/09/2020 |
| Token No | SM/20-21/25953 22/09/2020 | Serial | 049 Last Visit: 04/03/2021 |
| Patient Name | Mr. SUJOY DAS | Contact No | 9681286948 |
| Address | 5/1 LONKAR BAGAN,HARIJON ROAD,BAIDYABATI(M) | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||