Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09616 | Date 15/05/2021 |
| Token No | SM/21-22/1411 15/05/2021 | Serial | 019 Last Visit: 07/06/2021 |
| Patient Name | Mr. CHANDAN SEN | Contact No | 9331813538 |
| Address | DAKSIN RAJYADHARPUR | Age | 44 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||