Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02102 | Date 24/11/2018 |
| Token No | SM/18-19/4071 24/11/2018 | Serial | 001 Last Visit: 24/11/2018 |
| Patient Name | Mr. PRASHANTA SANYAL | Contact No | 9748165568 |
| Address | 6, CHTRA LAHIRI PARA | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 77 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||