Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03453 | Date 08/02/2019 |
| Token No | SM/18-19/8290 08/02/2019 | Serial | 016 Last Visit: 08/02/2019 |
| Patient Name | Mr. JAGABONDHU DAS | Contact No | |
| Address | 10 GOPAL CHANDRA STREET | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||