Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08687 | Date 02/09/2020 |
| Token No | SM/19-20/25320 02/09/2020 | Serial | 019 Last Visit: 03/09/2020 |
| Patient Name | Mr. TAPAN KUMAR PATRA | Contact No | 9748296224 |
| Address | B/301 DHEERAJ DARSHAN C. H. S. LTD KOKAN NAGAR , 2 , RAM KRISHNA BYE LANE CHATRA MANAPARA , BAIDYABATI(M) | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||