Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03134 | Date 22/01/2019 |
| Token No | SM/18-19/7262 22/01/2019 | Serial | 033 Last Visit: 22/01/2019 |
| Patient Name | Mr. SANKER DUTTA | Contact No | 8902508911 |
| Address | 36 CHATRA DUTTA PARA LANE | Age | 66 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||