Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03206 | Date 29/01/2019 |
| Token No | SM/19-20/3026 20/05/2019 | Serial | 074 Last Visit: 20/05/2019 |
| Patient Name | Mr. SANJAY SAMANTA | Contact No | 9830132657 |
| Address | A.P GHOSH ROAD CHATRA | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||