Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01519 | Date 05/10/2018 |
| Token No | SM/18-19/2757 11/10/2018 | Serial | 020 Last Visit: 29/10/2018 |
| Patient Name | Mr. BIKASH LAHA | Contact No | 8621050595 |
| Address | 130/B CHATRA BARUI PARA | Age | 71 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||