Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00334 | Date 10/08/2018 |
| Token No | SM/18-19/4003 20/11/2018 | Serial | 081 Last Visit: 20/11/2018 |
| Patient Name | Mr. GOPAL CHANDRA KUNDU | Contact No | |
| Address | 68, A.P GHOSH ROAD | Age | 68 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||