Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09595 | Date 07/05/2021 |
| Token No | SM/21-22/1356 12/05/2021 | Serial | 029 Last Visit: 12/05/2021 |
| Patient Name | Mr. GOUTAM DAS | Contact No | 9681420370 |
| Address | TALPUKUR PROMOTKOLI SERAMPORE( RAJHYADHARPUR GRAM PANCHYAT) | Age | 47 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||