Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02197 | Date 29/11/2018 |
| Token No | SM/18-19/4766 06/12/2018 | Serial | 021 Last Visit: 06/12/2018 |
| Patient Name | Mr. ASIM MUKHERJEE | Contact No | |
| Address | 5 CHATRA CHOWDHURY PARA | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 85 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||