Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07227 | Date 26/12/2019 |
| Token No | SM/19-20/16054 30/12/2019 | Serial | 043 Last Visit: 06/01/2020 |
| Patient Name | Mr. NEMAI PATRA | Contact No | 8478995639 |
| Address | CHATRA SHITLATALA G.T ROAD, BAIDYABATI(M) | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||