Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02503 | Date 13/12/2018 |
| Token No | SM/18-19/5177 13/12/2018 | Serial | 024 Last Visit: 13/12/2018 |
| Patient Name | Mr. SAMAR SAMANTA | Contact No | 9051564923 |
| Address | CHATRA CHAKRABORTY LANE | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||