Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02588 | Date 19/12/2018 |
| Token No | SM/20-21/28800 28/12/2020 | Serial | 012 Last Visit: 12/03/2021 |
| Patient Name | Mr. SUDHANSHU PAL | Contact No | 8902294180 |
| Address | GOBINDAPUR DIARA-712223 | Age | 58 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||