Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03057 | Date 18/01/2019 |
| Token No | SM/20-21/27811 26/11/2020 | Serial | 012 Last Visit: 03/11/2022 |
| Patient Name | Mr. MITHUN ASH | Contact No | 9804942280 |
| Address | 11 CHATRA DUTTAS LANE | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||