Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02614 | Date 20/12/2018 |
| Token No | SM/18-19/5539 20/12/2018 | Serial | 052 Last Visit: 20/12/2018 |
| Patient Name | Mr. RIYA SANTARA | Contact No | 9038511905 |
| Address | 140/A N S EVENEU | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||