Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03023 | Date 16/01/2019 |
| Token No | SM/21-22/1542 19/05/2021 | Serial | 019 Last Visit: 03/02/2022 |
| Patient Name | Mr. ASIM KR PAL | Contact No | 8013676535 |
| Address | 145/1 CHATRA TETUL TALA BAJAR, BAIDYABATI(M) | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||