Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09572 | Date 03/05/2021 |
| Token No | SM/21-22/1076 03/05/2021 | Serial | 024 Last Visit: 04/08/2022 |
| Patient Name | Mr. SUBRATA BOSE | Contact No | 6290051927 |
| Address | 37/1 SHIBTALA LANE SEORAPHULI | Age | 66 yrs Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||