Ticket for Outdoor Patient
| Ward No. | U-PHC No. | Registration No. 00120 | Date 04/08/2018 |
| Token No | SM/18-19/122 04/08/2018 | Serial | 018 Last Visit: 04/08/2018 |
| Patient Name | Mr. SAILEN SOM | Contact No | 9433735094 |
| Address | 24B BARUIPARA LANE, CHATRA | Age | 62.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 129/56 mmHg | Weight | 45 KG |
| Pulse Rate | 88 / min | Height | cm BMI: inf |
| Diagnosis | |||