Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02669 | Date 24/12/2018 |
| Token No | SM/18-19/7090 19/01/2019 | Serial | 023 Last Visit: 19/01/2019 |
| Patient Name | Mr. SUJIT KUMAR GHOSH | Contact No | 9903642175 |
| Address | 33 DR. CHOWDHURY PARA BY LANE | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||