Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00916 | Date 05/09/2018 |
| Token No | SM/20-21/25786 18/09/2020 | Serial | 036 Last Visit: 05/11/2020 |
| Patient Name | Mr. H K MALLICK | Contact No | 9903457034 |
| Address | 18 JAGAMOHON LEHIRI LANE | Age | 71 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||