Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02004 | Date 16/11/2018 |
| Token No | SM/18-19/3797 16/11/2018 | Serial | 030 Last Visit: 16/11/2018 |
| Patient Name | Mr. SANTOSH SARDAR | Contact No | |
| Address | BAGER BAGAN TELI PARA | Age | 80 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||