Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01734 | Date 29/10/2018 |
| Token No | SM/18-19/10952 20/03/2019 | Serial | 057 Last Visit: 25/04/2019 |
| Patient Name | Mr. LAKHINARAYAN MITRA | Contact No | 9830525593 |
| Address | 32, BHADURI LANE CHATRA | Age | 41 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||