Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02019 | Date 19/11/2018 |
| Token No | SM/18-19/3845 19/11/2018 | Serial | 012 Last Visit: 19/11/2018 |
| Patient Name | Mr. HEMANTA DUTTA | Contact No | 9051718534 |
| Address | 47B CHATRA BARUI PARA LANE | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||