Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01151 | Date 15/09/2018 |
| Token No | SM/18-19/1685 15/09/2018 | Serial | 005 Last Visit: 15/09/2018 |
| Patient Name | Mr. MADHAI DAS | Contact No | |
| Address | 3, CHATRA SHIDESWARI LANE | Age | 50.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||