Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02729 | Date 29/12/2018 |
| Token No | SM/18-19/5954 29/12/2018 | Serial | 009 Last Visit: 29/12/2018 |
| Patient Name | Mr. SWARUP SEN | Contact No | 8334942430 |
| Address | KALI BABU GHAT CHATRA | Age | 49 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 73 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||