Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02584 | Date 18/12/2018 |
| Token No | SM/18-19/5428 18/12/2018 | Serial | 037 Last Visit: 18/12/2018 |
| Patient Name | Mr. SHYAMAL DUTTA | Contact No | 9002390105 |
| Address | 12 ROBINDRA VHABON SWARANI | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||