Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04903 | Date 25/04/2019 |
| Token No | SM/19-20/1629 25/04/2019 | Serial | 015 Last Visit: 25/04/2019 |
| Patient Name | Mr. PARSHANTA MAJHI | Contact No | 8020344420 |
| Address | RAMPKRISHANA ROAD PAN PARA , BAIDYABTI(M) | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||