Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01263 | Date 22/09/2018 |
| Token No | SM/18-19/1910 22/09/2018 | Serial | 023 Last Visit: 22/09/2018 |
| Patient Name | Mr. SK CHOTU | Contact No | 9748252282 |
| Address | CHATRA MUSALMAN PARA | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||