Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01062 | Date 12/09/2018 |
| Token No | SM/18-19/1539 12/09/2018 | Serial | 005 Last Visit: 14/10/2019 |
| Patient Name | Mr. SAGAR GUI DAS | Contact No | 7449910582 |
| Address | 40CHATRA DAS PARA | Age | 15.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||