Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09777 | Date 30/06/2021 |
| Token No | SM/21-22/2715 30/06/2021 | Serial | 021 Last Visit: 21/06/2022 |
| Patient Name | Mr. SOUMEN DAS | Contact No | 8981692992 |
| Address | CHATRA SERAMPORE | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||