Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01931 | Date 12/11/2018 |
| Token No | SM/18-19/3558 12/11/2018 | Serial | 036 Last Visit: 12/11/2018 |
| Patient Name | Mr. SANTOSH SHARDAR | Contact No | |
| Address | CHATRA BAGHER BAGAN | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||