Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04022 | Date 06/03/2019 |
| Token No | SM/18-19/10469 12/03/2019 | Serial | 060 Last Visit: 23/03/2019 |
| Patient Name | Mr. ACHINTA PAUL | Contact No | 9674970854 |
| Address | 50 CHATRA DHARMATALA LANE | Age | 78 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||