Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09174 | Date 15/01/2021 |
| Token No | SM/21-22/7569 08/12/2021 | Serial | 023 Last Visit: 08/12/2021 |
| Patient Name | Mr. ANANTA DEB CHAKRABORTY | Contact No | 9874188435 |
| Address | 24 CHATRA CHOWDHURY PARA LANE | Age | 69 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||