Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00493 | Date 16/08/2018 |
| Token No | SM/18-19/555 16/08/2018 | Serial | 043 Last Visit: 16/08/2018 |
| Patient Name | Mr. DEBANIK BASU | Contact No | 8013626543 |
| Address | 16, CHATRA BAJAR ROAD | Age | 37.0 Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||