Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00145 | Date 06/08/2018 |
| Token No | SM/18-19/3799 16/11/2018 | Serial | 032 Last Visit: 07/08/2019 |
| Patient Name | Mr. GURUPADA DAS | Contact No | 9331072807 |
| Address | 36, BHADURI LANE | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||