Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09946 | Date 16/08/2021 |
| Token No | SM/21-22/4080 16/08/2021 | Serial | 004 Last Visit: 16/08/2021 |
| Patient Name | Mr. GORA CHAND SOM | Contact No | 9836940415 |
| Address | 15/1 GODAR BAGAN LANE SERAMPORE | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||