Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09175 | Date 15/01/2021 |
| Token No | SM/20-21/29397 15/01/2021 | Serial | 030 Last Visit: 29/10/2021 |
| Patient Name | Mr. GORA CHAND GHOSH | Contact No | 9432111785 |
| Address | 256, 66/1/D RAMKRISHNA ROAD BAIDYABATI(M) | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||