Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03111 | Date 21/01/2019 |
| Token No | SM/19-20/2325 08/05/2019 | Serial | 016 Last Visit: 09/12/2019 |
| Patient Name | Mr. HARU SANTRA | Contact No | 9836517776 |
| Address | DIARA | Age | 51 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||