Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01358 | Date 26/09/2018 |
| Token No | SM/18-19/2103 26/09/2018 | Serial | 032 Last Visit: 26/09/2018 |
| Patient Name | Mr. SAMIR DHARA | Contact No | |
| Address | JANGIPAARA | Age | 74 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||