Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00072 | Date 03/08/2018 |
| Token No | SM/19-20/15013 10/12/2019 | Serial | 030 Last Visit: 03/01/2020 |
| Patient Name | Mr. ADHIR KUMAR SOM | Contact No | 9831103612 |
| Address | 17/D CHATARA DUTTA PARA | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||