Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 08540 | Date 14/07/2020 |
| Token No | SM/20-21/27363 10/11/2020 | Serial | 004 Last Visit: 12/08/2021 |
| Patient Name | Mr. CHANDAN DAS | Contact No | 9433281757 |
| Address | 3A, KHAL DHAR LANE NEAR SHIB MANDIR SERAMPORE | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||