Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05711 | Date 10/07/2019 |
| Token No | SM/19-20/14212 28/11/2019 | Serial | 029 Last Visit: 28/11/2019 |
| Patient Name | Mr. JAGAMOHON DAS | Contact No | 9674312148 |
| Address | 3 CHATRA SEDHYSWARI LANE | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||