Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 10445 | Date 22/12/2021 |
| Token No | SM/21-22/8008 22/12/2021 | Serial | 028 Last Visit: 22/12/2021 |
| Patient Name | Mr. ASIM DUTTA | Contact No | 9674533238 |
| Address | 1/M RAILAND CIRCULAR ROAD | Age | 51 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||