Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02999 | Date 14/01/2019 |
| Token No | SM/18-19/6787 14/01/2019 | Serial | 078 Last Visit: 27/03/2019 |
| Patient Name | Mr. SWAPAN MANDAL | Contact No | 9831875332 |
| Address | SIDDHESWARI LANE, CHATRA | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||