Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02073 | Date 22/11/2018 |
| Token No | SM/18-19/4014 22/11/2018 | Serial | 009 Last Visit: 04/12/2018 |
| Patient Name | Mr. BIJOY SHEET | Contact No | 9007653926 |
| Address | SHIBTALA , BAIDYABATI(M) | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||