Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00072 | Date 03/08/2018 |
| Token No | SM/18-19/11237 26/03/2019 | Serial | 030 Last Visit: 03/01/2020 |
| Patient Name | Mr. ADHIR KUMAR SOM | Contact No | 9831103612 |
| Address | 17/D CHATARA DUTTA PARA | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||