Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 10236 | Date 26/10/2021 |
| Token No | SM/21-22/6294 26/10/2021 | Serial | 048 Last Visit: 26/10/2021 |
| Patient Name | Mr. SUSMITA DAS | Contact No | 9051882993 |
| Address | 9/B DHARMATALA LANE CHATRA SERAMPORE | Age | 25 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||