Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 01938 | Date 12/11/2018 |
| Token No | SM/19-20/6952 20/07/2019 | Serial | 055 Last Visit: 22/10/2020 |
| Patient Name | Mr. SK SAMSER ALI | Contact No | 9163833543 |
| Address | BARGA KHATRIYA PARA(BARABELUR) | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||