Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00850 | Date 31/08/2018 |
| Token No | SM/18-19/1457 10/09/2018 | Serial | 045 Last Visit: 10/09/2018 |
| Patient Name | Mr. SUKUMAR DAS | Contact No | 7450863134 |
| Address | 37 CHATRA DAS PARA | Age | 38.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||