Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00394 | Date 13/08/2018 |
| Token No | SM/18-19/10440 12/03/2019 | Serial | 031 Last Visit: 27/11/2019 |
| Patient Name | Mr. SOUMEN DAS | Contact No | 9051467696 |
| Address | 89, CHATRA BARUIPARA LANE | Age | 32 yrs Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||