Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01674 | Date 26/10/2018 |
| Token No | SM/18-19/10036 07/03/2019 | Serial | 039 Last Visit: 07/03/2019 |
| Patient Name | Mr. MUKUL MAL | Contact No | 8420014733 |
| Address | 109 CHATRA BARUI PARA LANE | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||