Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01193 | Date 18/09/2018 |
| Token No | SM/18-19/1763 18/09/2018 | Serial | 029 Last Visit: 18/09/2018 |
| Patient Name | Mr. SUBHAM DEY | Contact No | 9733269928 |
| Address | 52A CHATRA BARUI PARA LANE | Age | 23 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||