Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02273 | Date 01/12/2018 |
| Token No | SM/18-19/5125 12/12/2018 | Serial | 039 Last Visit: 28/12/2018 |
| Patient Name | Mr. KALIPADA GHOSH | Contact No | 9874059041 |
| Address | 16 CHATRA MUSALMAN PARA ROAD | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||