Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09121 | Date 05/01/2021 |
| Token No | SM/20-21/28996 05/01/2021 | Serial | 012 Last Visit: 05/01/2021 |
| Patient Name | Mr. SANKAR KAYAL | Contact No | 8981228050 |
| Address | 117/A TELI PARA LANE CHATRA , BAIDYABATI(M) | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||