Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03614 | Date 16/02/2019 |
| Token No | SM/18-19/8803 16/02/2019 | Serial | 027 Last Visit: 16/02/2019 |
| Patient Name | Mr. RAHUL DUTTA | Contact No | 9874748372 |
| Address | 67B CHATRA BARUI PARA | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 86 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||