Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02225 | Date 29/11/2018 |
| Token No | SM/18-19/4409 29/11/2018 | Serial | 070 Last Visit: 29/11/2018 |
| Patient Name | Mr. SUDIP PAL | Contact No | 8017058019 |
| Address | 10 BARUI PARA LANE | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||