Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03061 | Date 18/01/2019 |
| Token No | SM/18-19/7016 18/01/2019 | Serial | 020 Last Visit: 18/03/2020 |
| Patient Name | Mr. KAMALA KANTA DAS | Contact No | 9836541892 |
| Address | 66 CHATRA DHARMOTALA | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||