Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 12135 | Date 05/06/2023 |
| Token No | SM/22-23/22004 05/06/2023 | Serial | 024 Last Visit: 05/06/2023 |
| Patient Name | Mr. DEBJIT MAITY | Contact No | 8902096152 |
| Address | 15/1 CHATRA MUKHERJEE PARA, BAIDYABTI (M) | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||