Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10449 | Date 23/12/2021 |
| Token No | SM/21-22/8027 23/12/2021 | Serial | 008 Last Visit: 29/01/2022 |
| Patient Name | Mr. SAYAN DAS | Contact No | 8100392386 |
| Address | 31 DHARMATALA LANE CHATRA SERAMPORE | Age | 29 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||