Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00296 | Date 10/08/2018 |
| Token No | SM/18-19/8865 18/02/2019 | Serial | 038 Last Visit: 10/04/2019 |
| Patient Name | Mr. SUKUMAR LAHA | Contact No | 9883355847 |
| Address | 65/23 CHATRA DAS PARA | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||