Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03097 | Date 19/01/2019 |
| Token No | SM/20-21/26690 15/10/2020 | Serial | 033 Last Visit: 11/11/2020 |
| Patient Name | Mr. SANATAN DAS | Contact No | 9804704162 |
| Address | 58/7(125) SATCHASI PARA LANKAR BAGAN , BAIDYABATI (M) | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||