Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01187 | Date 18/09/2018 |
| Token No | SM/18-19/1754 18/09/2018 | Serial | 020 Last Visit: 18/09/2018 |
| Patient Name | Mr. BIJOY SHEET | Contact No | 7044767913 |
| Address | 96 SHIPTALA BY LANE | Age | 31 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 120/90 mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||