Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06828 | Date 11/11/2019 |
| Token No | SM/19-20/12971 11/11/2019 | Serial | 013 Last Visit: 11/11/2019 |
| Patient Name | Mr. RAJENDRA PRASAD ROUTH | Contact No | 9748200991 |
| Address | 54 DHARMATALA LANE | Age | 37 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||