Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04556 | Date 04/04/2019 |
| Token No | SM/19-20/275 04/04/2019 | Serial | 064 Last Visit: 04/04/2019 |
| Patient Name | Mr. SOUVIK KUMAR GHOSH | Contact No | 8420753706 |
| Address | 3 CHATRA DHARMA TALA BY LANE | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||