Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03034 | Date 17/01/2019 |
| Token No | SM/18-19/6935 17/01/2019 | Serial | 015 Last Visit: 17/01/2019 |
| Patient Name | Mr. BISWANATH DAS | Contact No | 9681769036 |
| Address | 27 CHATRA MUSALMAN PARA | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||