Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02909 | Date 08/01/2019 |
| Token No | SM/18-19/6510 08/01/2019 | Serial | 064 Last Visit: 08/01/2019 |
| Patient Name | Mr. PRAVAT CH. DUTTA | Contact No | 7278894609 |
| Address | 131/A CHATRA BARUI PARA LANE | Age | 32 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||