Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03803 | Date 22/02/2019 |
| Token No | SM/21-22/7238 27/11/2021 | Serial | 014 Last Visit: 27/11/2021 |
| Patient Name | Mr. SAGAR DOME | Contact No | 6290339198 |
| Address | CHATRA KALIBABUR GHAT | Age | 31 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||