Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02624 | Date 21/12/2018 |
| Token No | SM/18-19/5555 21/12/2018 | Serial | 005 Last Visit: 12/10/2023 |
| Patient Name | Mr. JIT PATRA | Contact No | 7044113677 |
| Address | 21 CHATRA BAZAR ROAD | Age | 30 Years,2 Months,6 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||