Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04220 | Date 15/03/2019 |
| Token No | SM/18-19/10567 15/03/2019 | Serial | 060 Last Visit: 10/11/2020 |
| Patient Name | Mr. SAFIULLA LASKAR | Contact No | 8926679534 |
| Address | 18 MUSALMAN PARA, CHATRA | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||