Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 08905 | Date 22/10/2020 |
| Token No | SM/20-21/26919 22/10/2020 | Serial | 007 Last Visit: 03/11/2020 |
| Patient Name | Mr. SHANKAR DAS | Contact No | 9123869474 |
| Address | 461 G T ROAD BOWBAZAR BAIDYABATI CHATRA (M) | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||