Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02328 | Date 04/12/2018 |
| Token No | SM/19-20/17149 24/01/2020 | Serial | 064 Last Visit: 28/03/2020 |
| Patient Name | Mr. SHUBHAM DAS | Contact No | 8420883432 |
| Address | 27/B A P GHOSH ROAD CHATRA | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||