Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02573 | Date 18/12/2018 |
| Token No | SM/18-19/6665 11/01/2019 | Serial | 022 Last Visit: 11/01/2019 |
| Patient Name | Mr. RATHIKANTO MAITI | Contact No | 9123651696 |
| Address | CHATRA MANNA PARA,BAIDYABATI(M) | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||