Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10000 | Date 27/08/2021 |
| Token No | SM/21-22/4493 27/08/2021 | Serial | 028 Last Visit: 27/08/2021 |
| Patient Name | Mr. ARUN KUMAR JOSH | Contact No | 9051824968 |
| Address | 10 A/ Z /2/A G.T ROAD PAMPA NAGAR SERAMPORE | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||