Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03133 | Date 22/01/2019 |
| Token No | SM/19-20/11040 24/09/2019 | Serial | 058 Last Visit: 03/12/2019 |
| Patient Name | Mr. AMARENDRA NATH KARAR | Contact No | 9748948694 |
| Address | 49 CHATRA DUTTA PARA | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||