Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02009 | Date 16/11/2018 |
| Token No | SM/18-19/5597 21/12/2018 | Serial | 047 Last Visit: 20/03/2021 |
| Patient Name | Mr. GOPAL CH. SADHUKHAN | Contact No | 8100112891 |
| Address | 12/B CHATRA MUSALMAN PARA ROAD | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||