Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02761 | Date 31/12/2018 |
| Token No | SM/18-19/6055 31/12/2018 | Serial | 054 Last Visit: 31/12/2018 |
| Patient Name | Mr. TUSARKANTI KHAN | Contact No | 8017937207 |
| Address | 39/A 5 CHATRA BARUI PARA | Age | 64 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||