Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04108 | Date 09/03/2019 |
| Token No | SM/18-19/10218 09/03/2019 | Serial | 009 Last Visit: 09/03/2019 |
| Patient Name | Mr. RAJIV CHAKRABORTY | Contact No | 9330871503 |
| Address | 41 A. P GHOSH ROAD CHATRA | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||