Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09274 | Date 03/03/2021 |
| Token No | SM/21-22/2201 12/06/2021 | Serial | 023 Last Visit: 22/07/2021 |
| Patient Name | Mr. SANTU GHOSH | Contact No | 8017569029 |
| Address | 41/2 SHITALA TALA ROAD ,CHATRA,BAIDYABATI(M) | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||