Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09999 | Date 27/08/2021 |
| Token No | SM/21-22/4491 27/08/2021 | Serial | 026 Last Visit: 27/08/2021 |
| Patient Name | Mr. KARTTIK SAMANTA | Contact No | |
| Address | 57/G/A G.T ROAD PAMPANAGAR CHATRA SERAMPORE | Age | 57 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||