Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02943 | Date 10/01/2019 |
| Token No | SM/18-19/6613 10/01/2019 | Serial | 040 Last Visit: 26/06/2019 |
| Patient Name | Mr. BABLU SADHUKHAN | Contact No | 9674813579 |
| Address | 3 CHATRA DHARMOTALA LANE | Age | 43 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||