Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05414 | Date 13/06/2019 |
| Token No | SM/19-20/4499 13/06/2019 | Serial | 054 Last Visit: 20/06/2019 |
| Patient Name | Mr. RAMMOHAN PATRA | Contact No | 9143897488 |
| Address | 2 RAMKRISHNA ROAD BYE LANE CHATRA BAIDYABATI(M) | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||