Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04330 | Date 20/03/2019 |
| Token No | SM/18-19/11398 27/03/2019 | Serial | 102 Last Visit: 27/03/2019 |
| Patient Name | Mr. TOTON GHOSH | Contact No | 9874697912 |
| Address | 18 BANIYA PARA LANE | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||