Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07579 | Date 19/02/2020 |
| Token No | SM/19-20/18347 19/02/2020 | Serial | 008 Last Visit: 19/02/2020 |
| Patient Name | Mr. SWAPAN SOM | Contact No | 9748810708 |
| Address | 24/A VHATRA BARUI PARA | Age | 61 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||