Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07250 | Date 30/12/2019 |
| Token No | SM/19-20/17332 28/01/2020 | Serial | 025 Last Visit: 24/02/2020 |
| Patient Name | Mr. RANGALAL SENAPATI | Contact No | 8017820141 |
| Address | 40 38/2 MUKHERJEE PARA BAIDYABATI | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||