Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03687 | Date 19/02/2019 |
| Token No | SM/18-19/8973 19/02/2019 | Serial | 003 Last Visit: 25/02/2019 |
| Patient Name | Mr. JEET NAYEK | Contact No | 7908749160 |
| Address | 35 SACHTASI PARA LANKAR BAGAN , BAIDYABATI (M) | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 90 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||