Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09705 | Date 11/06/2021 |
| Token No | SM/21-22/2138 11/06/2021 | Serial | 004 Last Visit: 11/06/2021 |
| Patient Name | Mr. SHANKER MAZUMDAR | Contact No | 7003897416 |
| Address | 32/Y DR. BAGAN LANE, | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||