Ticket for Outdoor Patient
| Ward No. | U-PHC No. | Registration No. 00141 | Date 06/08/2018 |
| Token No | SM/18-19/145 06/08/2018 | Serial | 006 Last Visit: 06/08/2018 |
| Patient Name | Mr. SHIBSANKAR MUKHERJEE | Contact No | |
| Address | 36, BAHADURI LANE ,CHATRA | Age | 30.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||