Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01360 | Date 26/09/2018 |
| Token No | SM/18-19/7246 22/01/2019 | Serial | 017 Last Visit: 22/01/2019 |
| Patient Name | Mr. NANDA DAS | Contact No | |
| Address | CHATRA DAS PARA HORIJON ROAD | Age | 44 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||