Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02236 | Date 30/11/2018 |
| Token No | SM/18-19/4434 30/11/2018 | Serial | 023 Last Visit: 30/11/2018 |
| Patient Name | Mr. BIKASH DEY | Contact No | 7596965473 |
| Address | 8 CHATRA CHOWDHURY PARA | Age | 43 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||