Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09623 | Date 19/05/2021 |
| Token No | SM/21-22/1547 19/05/2021 | Serial | 024 Last Visit: 19/05/2021 |
| Patient Name | Mr. GOPAL ROY | Contact No | 8478869219 |
| Address | CHATRA PAMPA NAGAR (BAIDHYABATY) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||