Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02799 | Date 03/01/2019 |
| Token No | SM/18-19/6178 03/01/2019 | Serial | 015 Last Visit: 03/01/2019 |
| Patient Name | Mr. LAL MOHAN KUNDU | Contact No | 9331445758 |
| Address | CHATRA DHARMOTALA BY LANE | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||