Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02678 | Date 24/12/2018 |
| Token No | SM/18-19/6258 04/01/2019 | Serial | 043 Last Visit: 24/01/2019 |
| Patient Name | Mr. DILIP BURMAN | Contact No | 9051291618 |
| Address | 11A LAHIRI PARA LANE | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||