Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 11563 | Date 12/09/2022 |
| Token No | SM/22-23/16640 12/09/2022 | Serial | 037 Last Visit: 12/09/2022 |
| Patient Name | Mr. GOPAL DAS | Contact No | 8017666543 |
| Address | 191 SHITALA TALA RD CHATRA BAIDYABATI | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||