Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00753 | Date 28/08/2018 |
| Token No | SM/18-19/9455 26/02/2019 | Serial | 008 Last Visit: 20/05/2019 |
| Patient Name | Mr. RANJIT PATRA | Contact No | 9836937077 |
| Address | BARA KAMLA PUR PASCHIM PARA | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||