Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01062 | Date 12/09/2018 |
| Token No | SM/19-20/5182 24/06/2019 | Serial | 048 Last Visit: 14/10/2019 |
| Patient Name | Mr. SAGAR GUI DAS | Contact No | 7449910582 |
| Address | 40CHATRA DAS PARA | Age | 15.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||