Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 09102 | Date 28/12/2020 |
| Token No | SM/20-21/29275 11/01/2021 | Serial | 037 Last Visit: 18/01/2021 |
| Patient Name | Mr. DULAL CHANDRA MIL | Contact No | 9007759846 |
| Address | 255/B/B/159 CHARABAGAN BAUREPARA BAIDYABATI M | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||