Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08709 | Date 05/09/2020 |
| Token No | SM/19-20/25470 05/09/2020 | Serial | 001 Last Visit: 05/09/2020 |
| Patient Name | Mr. DILIP PAL | Contact No | |
| Address | 3NO ARABINDA SARANI CHATRA | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||