Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02623 | Date 21/12/2018 |
| Token No | SM/18-19/5554 21/12/2018 | Serial | 004 Last Visit: 21/12/2018 |
| Patient Name | Mr. PINKU DUTTA | Contact No | |
| Address | CHATRA BARUI PARA | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||