Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01999 | Date 16/11/2018 |
| Token No | SM/18-19/3781 16/11/2018 | Serial | 014 Last Visit: 16/11/2018 |
| Patient Name | Mr. NANDA DULAL LHA | Contact No | 8017330575 |
| Address | CHATRA DUTTA PARA | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||