Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02233 | Date 30/11/2018 |
| Token No | SM/18-19/5078 11/12/2018 | Serial | 058 Last Visit: 11/12/2018 |
| Patient Name | Mr. AJIT DEY | Contact No | |
| Address | 23 CHATRA CHOWDHURY PARA | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||