Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01793 | Date 31/10/2018 |
| Token No | SM/18-19/3205 31/10/2018 | Serial | 009 Last Visit: 31/10/2018 |
| Patient Name | Mr. MALAY MITRA | Contact No | 9830516218 |
| Address | 24 CHATRA BAZAR ROAD | Age | 73 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 96 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||