Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 10378 | Date 04/12/2021 |
| Token No | SM/21-22/7449 04/12/2021 | Serial | 001 Last Visit: 04/12/2021 |
| Patient Name | Mr. GOUTAM DAS | Contact No | 6289187639 |
| Address | CHATRA ,DAS PARA HARIJON ROAD,BAIDYABATI(M) | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||