Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10659 | Date 10/02/2022 |
| Token No | SM/21-22/10139 22/02/2022 | Serial | 039 Last Visit: 22/02/2022 |
| Patient Name | Mr. SUBHAS CHAKRABARTY | Contact No | 9062643180 |
| Address | RAIGANJ UTTAR DINAJPUR 52/1 NABIN CHAKRABARTY LANE SERAMPORE | Age | 69 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||