Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03726 | Date 20/02/2019 |
| Token No | SM/18-19/9097 20/02/2019 | Serial | 035 Last Visit: 21/12/2019 |
| Patient Name | Mr. AVIJIT DAS | Contact No | 7044016626 |
| Address | 7 CHATRA DUTTA PARA LANE | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||