Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06512 | Date 23/09/2019 |
| Token No | SM/20-21/30993 20/03/2021 | Serial | 022 Last Visit: 20/03/2021 |
| Patient Name | Mr. MALAY SAMANTA | Contact No | 8240717170 |
| Address | 31/T/1 G. T. ROAD,BAIDYABATI(M) | Age | 37 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||