Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08617 | Date 03/08/2020 |
| Token No | SM/19-20/24680 03/08/2020 | Serial | 023 Last Visit: 03/08/2020 |
| Patient Name | Mr. SRIMANTA MAJHI | Contact No | 9088467299 |
| Address | 4NO BAGAR BAGAN CHATRA | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||