Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02242 | Date 30/11/2018 |
| Token No | SM/19-20/14177 27/11/2019 | Serial | 086 Last Visit: 27/11/2019 |
| Patient Name | Mr. TARUN GOPE | Contact No | |
| Address | 65/B F. D. ROADMALLICK PARA | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||