Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10015 | Date 01/09/2021 |
| Token No | SM/21-22/4613 01/09/2021 | Serial | 011 Last Visit: 01/09/2021 |
| Patient Name | Mr. AVIJIT MONDAL | Contact No | 9051631167 |
| Address | 164, G.T ROAD BAIDHYABATI | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||