Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 11055 | Date 27/05/2022 |
| Token No | SM/22-23/12959 27/05/2022 | Serial | 022 Last Visit: 15/06/2022 |
| Patient Name | Mr. RAMKRISHNA GUIN | Contact No | 8017481939 |
| Address | 76/35 GODAR BAGAN SERAMPORE, BAIDYABATI | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||