Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02617 | Date 20/12/2018 |
| Token No | SM/18-19/5544 20/12/2018 | Serial | 057 Last Visit: 20/12/2018 |
| Patient Name | Mr. SANKER PRASAD RAJAK | Contact No | 9883119990 |
| Address | 6/C S C CHATTERJEE SARANI | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||