Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02032 | Date 19/11/2018 |
| Token No | SM/18-19/4165 26/11/2018 | Serial | 038 Last Visit: 26/11/2018 |
| Patient Name | Mr. SUROJIT MAJUMDAR | Contact No | 9831194007 |
| Address | NOGA MOR, BAIDYABATI (M) | Age | 26 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||