Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09638 | Date 24/05/2021 |
| Token No | SM/21-22/1640 24/05/2021 | Serial | 018 Last Visit: 24/05/2021 |
| Patient Name | Mr. SAMAR DAS | Contact No | |
| Address | 34 PATIPARA CHATRA , BAIDYABATI(M) | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||