Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02582 | Date 18/12/2018 |
| Token No | SM/18-19/5421 18/12/2018 | Serial | 030 Last Visit: 18/12/2018 |
| Patient Name | Mr. SANDIPAN BARIK | Contact No | 9051384688 |
| Address | CHATRA SHATCHASI PARA | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 92 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||