Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02047 | Date 20/11/2018 |
| Token No | SM/18-19/3940 20/11/2018 | Serial | 018 Last Visit: 20/11/2018 |
| Patient Name | Mr. TAPAN KUMAR MALLIK | Contact No | 9874445777 |
| Address | M.C LAHIRI ROAD | Age | 75 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||