Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04914 | Date 25/04/2019 |
| Token No | SM/19-20/2658 13/05/2019 | Serial | 069 Last Visit: 24/05/2019 |
| Patient Name | Mr. SNEHAMOY SOM | Contact No | 9830426530 |
| Address | CHATRA CHOWDHURY PARA | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||