Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09706 | Date 11/06/2021 |
| Token No | SM/21-22/2139 11/06/2021 | Serial | 005 Last Visit: 11/06/2021 |
| Patient Name | Mr. SOMNATH BAG | Contact No | |
| Address | GAS GODAUN,BAIDYABATI(M) | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||