Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02289 | Date 03/12/2018 |
| Token No | SM/19-20/1157 18/04/2019 | Serial | 070 Last Visit: 18/04/2019 |
| Patient Name | Mr. GOPAL PATRA | Contact No | 8777797153 |
| Address | 19 N N ROY STREET | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||