Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03714 | Date 20/02/2019 |
| Token No | SM/18-19/9079 20/02/2019 | Serial | 017 Last Visit: 20/02/2019 |
| Patient Name | Mr. PRITAM GHOSH | Contact No | 8240406247 |
| Address | 10/A/2 CHATRA GHOSH PARA 1ST LANE | Age | 32 yrs Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||