Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00578 | Date 20/08/2018 |
| Token No | SM/19-20/5204 24/06/2019 | Serial | 070 Last Visit: 24/06/2019 |
| Patient Name | Mr. ASIT HALDAR | Contact No | 9748068816 |
| Address | 154, CHATRA BAGER BAGAN | Age | 23.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||