Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05436 | Date 14/06/2019 |
| Token No | SM/19-20/4601 14/06/2019 | Serial | 076 Last Visit: 21/06/2019 |
| Patient Name | Mr. SUBHASHIS MUKHERJEE | Contact No | 9836951896 |
| Address | 13 SIDHYSARI LANE ,CHATRA | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||