Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02622 | Date 21/12/2018 |
| Token No | SM/18-19/6511 08/01/2019 | Serial | 065 Last Visit: 08/01/2019 |
| Patient Name | Mr. ACHINTA ROUTH | Contact No | |
| Address | SANTOSHPUR TARAKESWAR | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||