Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01600 | Date 10/10/2018 |
| Token No | SM/18-19/2696 10/10/2018 | Serial | 021 Last Visit: 08/08/2019 |
| Patient Name | Mr. PRATAP SHANKAR DAS | Contact No | 8013156326 |
| Address | 80 RISHI BANKIM SARANI | Age | 61 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||