Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 01568 | Date 09/10/2018 |
| Token No | SM/19-20/13322 15/11/2019 | Serial | 055 Last Visit: 06/02/2020 |
| Patient Name | Mr. SUKUMAR GHOSH | Contact No | 9903444664 |
| Address | 50/D R.K ROAD CHATRA | Age | 58 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||