Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09193 | Date 20/01/2021 |
| Token No | SM/20-21/29916 30/01/2021 | Serial | 001 Last Visit: 30/01/2021 |
| Patient Name | Mr. JAGADISH BHATTCHARJEE | Contact No | |
| Address | JAGADDHATRITALA LEN NAYA BSTI, CHAMPADANI (M) | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||