Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01011 | Date 10/09/2018 |
| Token No | SM/18-19/1424 10/09/2018 | Serial | 012 Last Visit: 10/09/2018 |
| Patient Name | Mr. PHANIBHUSHAN SOM | Contact No | 8981587054 |
| Address | 19, CHATRA BARUI PARA | Age | 59.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 118/69 mmHg | Weight | 59 KG |
| Pulse Rate | 80 / min | Height | cm BMI: inf |
| Diagnosis | |||