Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09609 | Date 11/05/2021 |
| Token No | SM/21-22/1324 11/05/2021 | Serial | 042 Last Visit: 11/05/2021 |
| Patient Name | Mr. PRASENJIT RUIDAS | Contact No | 8013658369 |
| Address | 243/89/1 TELIPARA LANE CHATRA BAIDYABATI(M) | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||