Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06622 | Date 14/10/2019 |
| Token No | SM/19-20/11851 16/10/2019 | Serial | 069 Last Visit: 16/10/2019 |
| Patient Name | Mr. SHAMBHU NATH DAS | Contact No | 7651908896 |
| Address | 58(40) HARIJAN ROAD,CHATRA,BAIDYABATI(M) | Age | 21 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||