Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09044 | Date 14/12/2020 |
| Token No | SM/20-21/28808 28/12/2020 | Serial | 020 Last Visit: 28/12/2020 |
| Patient Name | Mr. SAMIR BANERJEE | Contact No | 8961411098 |
| Address | CHOTOBELU BELUMILKI , | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||