Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03715 | Date 20/02/2019 |
| Token No | SM/19-20/17402 01/02/2020 | Serial | 013 Last Visit: 01/02/2020 |
| Patient Name | Mr. AVIJIT PAL | Contact No | 9875354264 |
| Address | 10 CHATRA KUMAR PARA | Age | 31 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 79 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||