Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 09376 | Date 22/03/2021 |
| Token No | SM/20-21/31024 22/03/2021 | Serial | 002 Last Visit: 22/03/2021 |
| Patient Name | Mr. ASOKH DAS | Contact No | 9875383968 |
| Address | J N LAHIRI ROAD SERAMPORE | Age | 36 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||