Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03588 | Date 15/02/2019 |
| Token No | SM/18-19/8713 15/02/2019 | Serial | 001 Last Visit: 25/04/2019 |
| Patient Name | Mr. SAILENDRA NATH LAHA | Contact No | 9830337219 |
| Address | 35 BARUI PARA LANE,CHATRA | Age | 79 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||