Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09991 | Date 26/08/2021 |
| Token No | SM/21-22/4444 26/08/2021 | Serial | 028 Last Visit: 26/08/2021 |
| Patient Name | Mr. AVIJIT SHAW | Contact No | 9875689215 |
| Address | 108,TELI PARA BAGER BAGAN BAIDHYABATI | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||