Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07781 | Date 13/03/2020 |
| Token No | SM/19-20/19582 13/03/2020 | Serial | 056 Last Visit: 02/04/2020 |
| Patient Name | Mr. BONOMALI PAKIRA | Contact No | 9874922511 |
| Address | 55 CHATRA DHARMA TALA | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||