Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05499 | Date 20/06/2019 |
| Token No | SM/19-20/4958 20/06/2019 | Serial | 098 Last Visit: 20/06/2019 |
| Patient Name | Mr. SWADESH PATRA | Contact No | 8981173073 |
| Address | CHOTO BELU BELUMILKI | Age | 53 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||