Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02599 | Date 20/12/2018 |
| Token No | SM/19-20/2377 08/05/2019 | Serial | 068 Last Visit: 20/06/2019 |
| Patient Name | Mr. KRISHNA DAS | Contact No | 9748068816 |
| Address | 66, CHATRA DHARMOTALA LANE | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||