Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00769 | Date 28/08/2018 |
| Token No | SM/18-19/1798 19/09/2018 | Serial | 010 Last Visit: 09/09/2019 |
| Patient Name | Mr. BECHU RAM PALODHI | Contact No | 7278736439 |
| Address | 21, CHATRA CHOWDHURY PARA / LANE | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||