Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02767 | Date 31/12/2018 |
| Token No | SM/18-19/6156 02/01/2019 | Serial | 065 Last Visit: 02/01/2019 |
| Patient Name | Mr. SANKER DEY | Contact No | 9339324932 |
| Address | CHATRA TETUL TALAS.BAIDYABATY(M) | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||