Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02568 | Date 17/12/2018 |
| Token No | SM/18-19/5386 17/12/2018 | Serial | 067 Last Visit: 23/02/2019 |
| Patient Name | Mr. AVIK DAS | Contact No | 9903211587 |
| Address | BAIDYA PARA ,BAIDYABATY(M) | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||