Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05399 | Date 12/06/2019 |
| Token No | SM/19-20/11710 14/10/2019 | Serial | 104 Last Visit: 03/12/2019 |
| Patient Name | Mr. RAJ KUMAR DAS | Contact No | 9800068025 |
| Address | GOPALPUR | Age | 35 Y Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||