Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08865 | Date 14/10/2020 |
| Token No | SM/20-21/26652 14/10/2020 | Serial | 022 Last Visit: 14/10/2020 |
| Patient Name | Mr. GOPAL PAL | Contact No | 9674143876 |
| Address | 94/A/2 KHATIR BAZAR LANE SERAMPORE, RISHRA | Age | 58 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||