Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08943 | Date 06/11/2020 |
| Token No | SM/20-21/28208 07/12/2020 | Serial | 052 Last Visit: 07/01/2021 |
| Patient Name | Mr. DIPAK MITRA | Contact No | 9051297414 |
| Address | 27/I/1, DOCTOR BAGAN LANE SERAMPORE MALLICKPARA | Age | 57 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||