Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02672 | Date 24/12/2018 |
| Token No | SM/18-19/5703 24/12/2018 | Serial | 026 Last Visit: 24/12/2018 |
| Patient Name | Mr. SUMANTA ROY | Contact No | 9681922239 |
| Address | 25 CHOWDHURY PARA | Age | 44 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||