Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00982 | Date 07/09/2018 |
| Token No | SM/19-20/2461 10/05/2019 | Serial | 058 Last Visit: 10/05/2019 |
| Patient Name | Mr. BRAJA GOPAL LAHA | Contact No | 7439187122 |
| Address | 13/A CHATRA DUTTA PARA | Age | 43.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||