Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01434 | Date 01/10/2018 |
| Token No | SM/19-20/152 03/04/2019 | Serial | 007 Last Visit: 25/06/2019 |
| Patient Name | Mr. GOPAL SAHA | Contact No | 8001229975 |
| Address | KATWA | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||