Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 09156 | Date 11/01/2021 |
| Token No | SM/20-21/29263 11/01/2021 | Serial | 025 Last Visit: 22/01/2021 |
| Patient Name | Mr. MADHUSUDAN DASGUPTA | Contact No | 8910081303 |
| Address | 37 SOUDAMINI NAGAR DAKSHIN PARA 2ND LANE RISHRA | Age | 68 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||