Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03764 | Date 21/02/2019 |
| Token No | SM/18-19/9185 21/02/2019 | Serial | 047 Last Visit: 18/04/2019 |
| Patient Name | Mr. RABINDRANATH SAMANTA | Contact No | 9432391776 |
| Address | 40/1 A.P GHOSH ROAD CHATRA | Age | 64 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 150/70 mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||