Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02658 | Date 22/12/2018 |
| Token No | SM/18-19/5672 22/12/2018 | Serial | 049 Last Visit: 22/12/2018 |
| Patient Name | Mr. BHASKAR DAS | Contact No | 9903246195 |
| Address | 24/A CHAKRABORTY LANE | Age | 51 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||