Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02173 | Date 28/11/2018 |
| Token No | SM/18-19/8026 05/02/2019 | Serial | 017 Last Visit: 18/04/2019 |
| Patient Name | Mr. GOPAL PAL | Contact No | 9051622972 |
| Address | BOU BAJAR | Age | 82 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||