Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04394 | Date 26/03/2019 |
| Token No | SM/21-22/2342 18/06/2021 | Serial | 011 Last Visit: 18/06/2021 |
| Patient Name | Mr. TAPAN DAS | Contact No | 6294503105 |
| Address | 3B CHATRA GHOSH PARA 2ND LANE | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||