Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09610 | Date 11/05/2021 |
| Token No | SM/21-22/1327 11/05/2021 | Serial | 045 Last Visit: 11/05/2021 |
| Patient Name | Mr. DEEP RUI DAS | Contact No | 9748809720 |
| Address | 243/1/A TELIPARA LANE G T ROAD BAIDYABATI(M) | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||