Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09130 | Date 06/01/2021 |
| Token No | SM/20-21/29207 08/01/2021 | Serial | 045 Last Visit: 08/01/2021 |
| Patient Name | Mr. SIBUNATH PARAMANIK | Contact No | 9609500070 |
| Address | 52/A G.D BHATTCHARJEE LANE CHATRA , BAIDYABATI(M) | Age | 76 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||