Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05699 | Date 08/07/2019 |
| Token No | SM/19-20/6064 08/07/2019 | Serial | 037 Last Visit: 08/07/2019 |
| Patient Name | Mr. RAM REKHA MONDAL | Contact No | 9163205896 |
| Address | SIDDARTH PARA NEAR POWER HOUSE | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||