Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01070 | Date 12/09/2018 |
| Token No | SM/18-19/1827 19/09/2018 | Serial | 039 Last Visit: 19/09/2018 |
| Patient Name | Mr. SIBSANKAR DAS | Contact No | 9830462582 |
| Address | 3 CHATRA SHIDDESWARIE LANE | Age | 47.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||