Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04997 | Date 02/05/2019 |
| Token No | SM/19-20/2079 02/05/2019 | Serial | 050 Last Visit: 02/05/2019 |
| Patient Name | Mr. PAMPA KHELO | Contact No | 9007620590 |
| Address | CHATRA BOU BAZAR, BAIDYABATT(M) | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||