Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05713 | Date 10/07/2019 |
| Token No | SM/19-20/6178 10/07/2019 | Serial | 046 Last Visit: 30/07/2019 |
| Patient Name | Mr. TAPAN PAL | Contact No | 9433215110 |
| Address | 25 CHATRA KUMAR PARA | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||