Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02972 | Date 11/01/2019 |
| Token No | SM/18-19/6706 11/01/2019 | Serial | 063 Last Visit: 11/01/2019 |
| Patient Name | Mr. SUBHANKER GARAI | Contact No | 7685843556 |
| Address | CHATRA DHARMA TALA | Age | 23 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||