Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02734 | Date 29/12/2018 |
| Token No | SM/18-19/5965 29/12/2018 | Serial | 020 Last Visit: 29/12/2018 |
| Patient Name | Mr. RATAN RAY | Contact No | |
| Address | 18 RAY GHAT LANE | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||