Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09624 | Date 19/05/2021 |
| Token No | SM/21-22/1548 19/05/2021 | Serial | 025 Last Visit: 19/05/2021 |
| Patient Name | Mr. SANKAR DAS | Contact No | 9804775151 |
| Address | PROMOD POLLY SERAMPORE | Age | 33 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||