Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03176 | Date 25/01/2019 |
| Token No | SM/21-22/1769 29/05/2021 | Serial | 008 Last Visit: 26/11/2021 |
| Patient Name | Mr. SAJAL DAS | Contact No | 9088698278 |
| Address | CHATRA MANIK GHOSH BAGAN , BAIDYABATI(M) | Age | 26 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||