Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08870 | Date 15/10/2020 |
| Token No | SM/21-22/288 08/04/2021 | Serial | 012 Last Visit: 08/04/2021 |
| Patient Name | Mr. SUKANTA DAS | Contact No | 8420987878 |
| Address | 10 P.N.K.B. LANE.CHATRA | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||