Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02147 | Date 27/11/2018 |
| Token No | SM/18-19/4216 27/11/2018 | Serial | 008 Last Visit: 01/02/2019 |
| Patient Name | Mr. KAMAL KR DAS | Contact No | 9143695656 |
| Address | 63, A.P GHOSH ROAD CHATRA | Age | 76 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||