Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04259 | Date 16/03/2019 |
| Token No | SM/19-20/1024 17/04/2019 | Serial | 031 Last Visit: 03/06/2019 |
| Patient Name | Mr. ASIM KUMAR DAS | Contact No | 9836267972 |
| Address | 37/A CHATRA DHARMOTALA LANE | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||