Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04201 | Date 15/03/2019 |
| Token No | SM/18-19/10511 15/03/2019 | Serial | 004 Last Visit: 15/03/2019 |
| Patient Name | Mr. DHIREN RAY | Contact No | 8972585878 |
| Address | DIPUR , P.S-DADPUR | Age | 63 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||