Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05772 | Date 15/07/2019 |
| Token No | SM/19-20/6476 15/07/2019 | Serial | 019 Last Visit: 24/07/2019 |
| Patient Name | Mr. ASHOKE PATRA | Contact No | |
| Address | 19B N.N. ROY STREET | Age | 54 Y Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||