Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00397 | Date 13/08/2018 |
| Token No | SM/18-19/437 13/08/2018 | Serial | 028 Last Visit: 13/08/2018 |
| Patient Name | Mr. SUPRABHAT PAL | Contact No | 8981171610 |
| Address | 17, P.N.K. BANERJEE LANE | Age | 26.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||