Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08864 | Date 14/10/2020 |
| Token No | SM/20-21/26651 14/10/2020 | Serial | 021 Last Visit: 14/10/2020 |
| Patient Name | Mr. SAMAR CHANDRA CHANDRA | Contact No | 9674550596 |
| Address | 36, 3 NATUN GRAM NITYANANDA PALLY , RISHRA | Age | 63 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||