Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01807 | Date 31/10/2018 |
| Token No | SM/18-19/3242 31/10/2018 | Serial | 046 Last Visit: 31/10/2018 |
| Patient Name | Mr. MRIDUL DAS | Contact No | 9051731385 |
| Address | 27 CHATRA BHADURI PARA LANE | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||