Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09115 | Date 31/12/2020 |
| Token No | SM/20-21/29650 22/01/2021 | Serial | 005 Last Visit: 22/01/2021 |
| Patient Name | Mr. BUDDHADEB ROY | Contact No | 9088886353 |
| Address | TELIPARA CHATRA,BAIDYABATI(M) | Age | 37 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||