Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05068 | Date 11/05/2019 |
| Token No | SM/19-20/2524 11/05/2019 | Serial | 012 Last Visit: 11/05/2019 |
| Patient Name | Mr. AMIT KUMAR | Contact No | 8009074409 |
| Address | 13 DR. P N MUKHERJEE STREET | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||