Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10161 | Date 30/09/2021 |
| Token No | SM/21-22/5633 30/09/2021 | Serial | 016 Last Visit: 30/09/2021 |
| Patient Name | Mr. NANDA KISHORE DAS | Contact No | 8900140496 |
| Address | 35,KUMIR JOLA ROAD | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||