Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01797 | Date 31/10/2018 |
| Token No | SM/21-22/4033 13/08/2021 | Serial | 028 Last Visit: 13/08/2021 |
| Patient Name | Mr. KALIPADA DAS | Contact No | 8420845550 |
| Address | CHATRA SHITALATALA | Age | 57 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||