Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01209 | Date 19/09/2018 |
| Token No | SM/18-19/1801 19/09/2018 | Serial | 013 Last Visit: 19/09/2018 |
| Patient Name | Mr. MONIKANTA POLLEY | Contact No | 8100819799 |
| Address | RAJA K.L GOSWAMI STREET | Age | 45 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 150/80 mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||