Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 09208 | Date 25/01/2021 |
| Token No | SM/20-21/29727 25/01/2021 | Serial | 011 Last Visit: 25/01/2021 |
| Patient Name | Mr. BIJAY GHORAI | Contact No | 704462946 |
| Address | JETEN LEHIRI ROAD | Age | 23 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||