Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09159 | Date 11/01/2021 |
| Token No | SM/20-21/29271 11/01/2021 | Serial | 033 Last Visit: 19/01/2021 |
| Patient Name | Mr. NEMAI DAS | Contact No | 9163571982 |
| Address | 25/A KUMIRJALA ROAD, | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||