Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07335 | Date 14/01/2020 |
| Token No | SM/21-22/6435 30/10/2021 | Serial | 004 Last Visit: 30/10/2021 |
| Patient Name | Mr. SURAJ DUTTA | Contact No | 9874262013 |
| Address | PAHALMPUR, PAHALAMPUR DIARA | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||