Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02810 | Date 03/01/2019 |
| Token No | SM/18-19/6215 03/01/2019 | Serial | 052 Last Visit: 03/01/2019 |
| Patient Name | Mr. AMARNATH ADHIKARY | Contact No | 9153870962 |
| Address | CHATRA CHOWDHURY PARA (ALOK BHAWAN) | Age | 69 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||