Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02080 | Date 22/11/2018 |
| Token No | SM/18-19/5035 11/12/2018 | Serial | 015 Last Visit: 11/12/2018 |
| Patient Name | Mr. JAYNTA MISHRA | Contact No | 8167587003 |
| Address | 34, CHATRA BAJAR ROAD | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 97 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||