Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05792 | Date 15/07/2019 |
| Token No | SM/19-20/6552 15/07/2019 | Serial | 095 Last Visit: 15/07/2019 |
| Patient Name | Mr. AMARNATH DAS | Contact No | 9830658065 |
| Address | B.L.C. MILLS BYE LANE | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||