Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01802 | Date 31/10/2018 |
| Token No | SM/18-19/3594 12/11/2018 | Serial | 072 Last Visit: 22/03/2021 |
| Patient Name | Mr. DEBABRATA SARKAR | Contact No | |
| Address | 28 CHATRA POTI PARA | Age | 39 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||