Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09029 | Date 05/12/2020 |
| Token No | SM/20-21/28144 05/12/2020 | Serial | 012 Last Visit: 05/12/2020 |
| Patient Name | Mr. BINOD KUMAR RAJVHOR | Contact No | 8820164044 |
| Address | 4/D BORO BAGAN LANE, | Age | 46 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||