Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06358 | Date 09/09/2019 |
| Token No | SM/19-20/10001 09/09/2019 | Serial | 005 Last Visit: 09/09/2019 |
| Patient Name | Mr. SUSANTA GARAI | Contact No | 9239664064 |
| Address | G.T. ROAD, MORADAN, BAIDYABATI (M) | Age | 38 Y Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||