Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01725 | Date 27/10/2018 |
| Token No | SM/18-19/8751 15/02/2019 | Serial | 039 Last Visit: 15/02/2019 |
| Patient Name | Mr. SRISTI BISWASH | Contact No | 8013216584 |
| Address | CHATRA POMPA NAGAR | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||