Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04217 | Date 15/03/2019 |
| Token No | SM/18-19/10557 15/03/2019 | Serial | 050 Last Visit: 15/03/2019 |
| Patient Name | Mr. SUMIT PAKHIRA | Contact No | 9874922511 |
| Address | 50 CHATRA DHARMOTALA SERAMPORE | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||