Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06581 | Date 30/09/2019 |
| Token No | SM/19-20/11321 30/09/2019 | Serial | 046 Last Visit: 30/09/2019 |
| Patient Name | Mr. JUGAL GHOSH | Contact No | 7001727299 |
| Address | 27/2 KUMOR PARA LANE,CHATRA, | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||