Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00803 | Date 29/08/2018 |
| Token No | SM/18-19/1009 29/08/2018 | Serial | 015 Last Visit: 29/08/2018 |
| Patient Name | Mr. SK MOUDUR | Contact No | 789018112 |
| Address | 5A CHATRA MUSALMAN PARA | Age | 34.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/85 mmHg | Weight | 84 KG |
| Pulse Rate | 76 / min | Height | cm BMI: inf |
| Diagnosis | |||