Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07253 | Date 30/12/2019 |
| Token No | SM/19-20/16439 09/01/2020 | Serial | 040 Last Visit: 09/01/2020 |
| Patient Name | Mr. JAYDEB DHARA | Contact No | 9433064273 |
| Address | DHANYAHANA ILAHIPUR | Age | 59 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 72 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||