Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02034 | Date 19/11/2018 |
| Token No | SM/19-20/16927 20/01/2020 | Serial | 040 Last Visit: 20/01/2020 |
| Patient Name | Mr. BECHU RAM GHOSH | Contact No | 9874635582 |
| Address | 34, CHATRA LAHIRI PARA | Age | 71 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||