Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02429 | Date 10/12/2018 |
| Token No | SM/19-20/1004 17/04/2019 | Serial | 011 Last Visit: 17/04/2019 |
| Patient Name | Mr. SUDARSAN KHAMARU | Contact No | 9830540950 |
| Address | 90 CHATRA MANNA PARA,BAIDAYBATY (M) | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 72.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||