Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08005 | Date 03/04/2020 |
| Token No | SM/21-22/4923 09/09/2021 | Serial | 021 Last Visit: 10/09/2021 |
| Patient Name | Mr. SUGOTO HATI | Contact No | 9432347905 |
| Address | 40 BAHIR SERAMPORE, | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||