Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02449 | Date 10/12/2018 |
| Token No | SM/18-19/5000 10/12/2018 | Serial | 048 Last Visit: 10/12/2018 |
| Patient Name | Mr. SWPAN DAS | Contact No | 9874137278 |
| Address | 19 P N MUKHERJEE STREET | Age | 67 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||