Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02484 | Date 12/12/2018 |
| Token No | SM/18-19/5130 12/12/2018 | Serial | 044 Last Visit: 12/02/2019 |
| Patient Name | Mr. KARTIK SAMANTA | Contact No | |
| Address | CHATRA PAMPANAGAR BAIDYABATI | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||