Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05825 | Date 18/07/2019 |
| Token No | SM/19-20/6787 18/07/2019 | Serial | 062 Last Visit: 04/06/2020 |
| Patient Name | Mr. SK MABIA | Contact No | 9836596552 |
| Address | 27 CHATRA MUSALMAN PARA BYE LANE | Age | 76 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||