Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01624 | Date 11/10/2018 |
| Token No | SM/18-19/2767 11/10/2018 | Serial | 030 Last Visit: 11/10/2018 |
| Patient Name | Mr. CHANDAN MAJHI | Contact No | 9382441755 |
| Address | CHATRA , P N MUKHAJEE STREET | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||