Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00981 | Date 07/09/2018 |
| Token No | SM/19-20/5567 28/06/2019 | Serial | 071 Last Visit: 28/06/2019 |
| Patient Name | Mr. PACHU GOPAL PAUL | Contact No | |
| Address | 14 BARUI PARA LANE | Age | 87 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||