Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02430 | Date 10/12/2018 |
| Token No | SM/18-19/4956 10/12/2018 | Serial | 004 Last Visit: 29/05/2019 |
| Patient Name | Mr. CHANDU DAS | Contact No | 9339374458 |
| Address | GOSWAMI PARA | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 77 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||