Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00916 | Date 05/09/2018 |
| Token No | SM/18-19/10910 20/03/2019 | Serial | 015 Last Visit: 05/11/2020 |
| Patient Name | Mr. H K MALLICK | Contact No | 9903457034 |
| Address | 18 JAGAMOHON LEHIRI LANE | Age | 71 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||