Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02228 | Date 30/11/2018 |
| Token No | SM/18-19/4412 30/11/2018 | Serial | 001 Last Visit: 30/11/2018 |
| Patient Name | Mr. CHATTU NAYEK | Contact No | 7908749160 |
| Address | 35 CHATRA LANKAR BAGAN , BAIDYABATI(M) | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 88 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||