Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03261 | Date 31/01/2019 |
| Token No | SM/18-19/7690 31/01/2019 | Serial | 064 Last Visit: 31/01/2019 |
| Patient Name | Mr. LAKHI KANTO SOM | Contact No | 9903526743 |
| Address | CHATRA, DUTTA PARA | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||