Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09865 | Date 23/07/2021 |
| Token No | SM/21-22/3394 23/07/2021 | Serial | 010 Last Visit: 23/07/2021 |
| Patient Name | Mr. NABAKUMAR PATRA | Contact No | 9836641031 |
| Address | 42,KUMIR JALA ROAD SERAMPORE | Age | 51 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||