Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03627 | Date 18/02/2019 |
| Token No | SM/18-19/8836 18/02/2019 | Serial | 009 Last Visit: 25/02/2019 |
| Patient Name | Mr. SOUVIK ADHIKARY | Contact No | 6290428858 |
| Address | 14 CHATRA CHOWDHURY PARA | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||