Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02321 | Date 04/12/2018 |
| Token No | SM/18-19/4629 04/12/2018 | Serial | 015 Last Visit: 04/12/2018 |
| Patient Name | Mr. HEMONTO MUKHERJEE | Contact No | |
| Address | 16 CHATRA CHOWDHURY PARA | Age | 58 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||