Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02361 | Date 05/12/2018 |
| Token No | SM/18-19/5622 21/12/2018 | Serial | 072 Last Visit: 21/12/2018 |
| Patient Name | Mr. JANKI DAS | Contact No | |
| Address | 31 CHATRA SHITLATALA | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||