Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02564 | Date 17/12/2018 |
| Token No | SM/18-19/5373 17/12/2018 | Serial | 054 Last Visit: 17/12/2018 |
| Patient Name | Mr. SUPARNA SAHA | Contact No | |
| Address | BAIDYABATI (M) | Age | 30 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||