Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00615 | Date 21/08/2018 |
| Token No | SM/19-20/15992 28/12/2019 | Serial | 030 Last Visit: 20/05/2020 |
| Patient Name | Mr. GOUR MAOHAN RUI DAS | Contact No | |
| Address | HARIJAN ROAD GURUDAS PARA | Age | 75.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||