Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05982 | Date 29/07/2019 |
| Token No | SM/19-20/21927 05/05/2020 | Serial | 008 Last Visit: 05/05/2020 |
| Patient Name | Mr. RAJENDRA SHAW | Contact No | 8420694601 |
| Address | 307/79 RAM KRISHNA ROAD CHATRA , BAIDYABTI(M) | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||