Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01369 | Date 27/09/2018 |
| Token No | SM/18-19/2133 27/09/2018 | Serial | 014 Last Visit: 28/05/2025 |
| Patient Name | Mr. SUMAN DAS | Contact No | 7003480347 |
| Address | 113, CHATRA DAS PARA | Age | 15 Years,4 Months,25 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||