Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 12006 | Date 28/03/2023 |
| Token No | SM/22-23/20884 28/03/2023 | Serial | 001 Last Visit: 28/03/2023 |
| Patient Name | Mr. SHAMBU BASALI | Contact No | 9359186350 |
| Address | 130/113 SHITALATALA ROAD BAIDYABATI | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||