Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03558 | Date 13/02/2019 |
| Token No | SM/18-19/8608 13/02/2019 | Serial | 075 Last Visit: 13/02/2019 |
| Patient Name | Mr. SUBIRAN ADHIKARI | Contact No | 9874979380 |
| Address | 13/A CHATRA CHOWDHURI PARA LANE | Age | 29 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||