Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01654 | Date 12/10/2018 |
| Token No | SM/18-19/5436 18/12/2018 | Serial | 045 Last Visit: 27/12/2018 |
| Patient Name | Mr. UTPAL MALLICK | Contact No | 9231319241 |
| Address | CHATRA SETALATALA | Age | 42 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||