Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04073 | Date 07/03/2019 |
| Token No | SM/18-19/10102 07/03/2019 | Serial | 105 Last Visit: 13/03/2020 |
| Patient Name | Mr. ACHINTA MATI | Contact No | 8697472758 |
| Address | 7A THAKUR DAS BABU LANE | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||