Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05774 | Date 15/07/2019 |
| Token No | SM/19-20/6490 15/07/2019 | Serial | 033 Last Visit: 15/07/2019 |
| Patient Name | Mr. BISHU KUMAR RAM | Contact No | 8013309398 |
| Address | CHHATUGUNJ BAIDYABATI (M)SHEORAPHULI | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 77 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||