Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 00170 | Date 06/08/2018 |
| Token No | SM/18-19/175 06/08/2018 | Serial | 036 Last Visit: 18/09/2018 |
| Patient Name | Mr. SK RAJU | Contact No | 9681296531 |
| Address | 36, SILBAGAN SERAMPORE | Age | 40 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 121/104 mmHg | Weight | 69 KG |
| Pulse Rate | 110 / min | Height | cm BMI: inf |
| Diagnosis | |||