Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00941 | Date 06/09/2018 |
| Token No | SM/18-19/6898 16/01/2019 | Serial | 044 Last Visit: 29/01/2019 |
| Patient Name | Mr. MAHADEB MALLICK | Contact No | |
| Address | CHATRA DHARMOTALA | Age | 50.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||