Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03737 | Date 20/02/2019 |
| Token No | SM/18-19/9127 20/02/2019 | Serial | 065 Last Visit: 20/02/2019 |
| Patient Name | Mr. JAY PARUI | Contact No | 8777426037 |
| Address | CHATRA LANKAR BAGAN BAIDYABATI(M) | Age | 26 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||