Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01995 | Date 16/11/2018 |
| Token No | SM/18-19/3771 16/11/2018 | Serial | 004 Last Visit: 16/11/2018 |
| Patient Name | Mr. PRASANTA DAS | Contact No | 8981738327 |
| Address | CHATRA SHITALATALA | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||