Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09191 | Date 19/01/2021 |
| Token No | SM/20-21/29535 19/01/2021 | Serial | 029 Last Visit: 19/01/2021 |
| Patient Name | Mr. SANJIT MONDAL | Contact No | |
| Address | CHATRA BAU BAZAR TELI PARA BAGER BAGAN , BAIDYABATI(M) | Age | 37 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||