Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03832 | Date 23/02/2019 |
| Token No | SM/20-21/30068 04/02/2021 | Serial | 004 Last Visit: 07/09/2021 |
| Patient Name | Mr. SUJOY SADHUKHAN | Contact No | 9836534839 |
| Address | 3/A/1 CHATRA DHARMOTALA LANE | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||