Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09180 | Date 16/01/2021 |
| Token No | SM/20-21/29434 16/01/2021 | Serial | 011 Last Visit: 18/01/2021 |
| Patient Name | Mr. SUPRIYO KARMOKAR | Contact No | 9836596469 |
| Address | 2/B SIDDHESWARI LANE CHATRA SERAMPORE | Age | 43 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||