Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09200 | Date 21/01/2021 |
| Token No | SM/20-21/29621 21/01/2021 | Serial | 041 Last Visit: 21/01/2021 |
| Patient Name | Mr. FULCHAND MONDAL | Contact No | 9163248578 |
| Address | 72 G/A G T ROAD MARADAN NABAGRAM , BAIDYABATI(M) | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||