Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04017 | Date 05/03/2019 |
| Token No | SM/18-19/9893 05/03/2019 | Serial | 094 Last Visit: 05/03/2019 |
| Patient Name | Mr. KOUSIK ROY | Contact No | 8420563623 |
| Address | 2 PN CHAKRABORTY LANE | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 82 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||