Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02103 | Date 24/11/2018 |
| Token No | SM/19-20/4489 13/06/2019 | Serial | 044 Last Visit: 28/06/2019 |
| Patient Name | Mr. BISWAJIT DUTTA | Contact No | 9163170998 |
| Address | 130 CHATRA BARUI PARA | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||