Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00922 | Date 05/09/2018 |
| Token No | SM/18-19/4110 24/11/2018 | Serial | 040 Last Visit: 15/12/2018 |
| Patient Name | Mr. ASIS BANDYOPADHYAY | Contact No | 8697748700 |
| Address | 12B, DUTTA\'S LANE, CHATRA | Age | 47.6 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||