Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02520 | Date 14/12/2018 |
| Token No | SM/18-19/5491 20/12/2018 | Serial | 004 Last Visit: 20/12/2018 |
| Patient Name | Mr. RADHESHYAM ROY | Contact No | 6291397378 |
| Address | CHATRA BAURI PARA | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||