Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00896 | Date 04/09/2018 |
| Token No | SM/18-19/5090 12/12/2018 | Serial | 004 Last Visit: 07/04/2022 |
| Patient Name | Mr. SHIB NATH DHARA | Contact No | 9674227128 |
| Address | 39/A BHATCHARJEE PARA CHATRA | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||