Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01919 | Date 12/11/2018 |
| Token No | SM/18-19/4140 26/11/2018 | Serial | 013 Last Visit: 10/02/2020 |
| Patient Name | Mr. TARAPADA CHOWDHURY | Contact No | |
| Address | CHATRA CHOWDHURY PARA(DOLTALA) | Age | 82 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||