Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 00969 | Date 07/09/2018 |
| Token No | SM/18-19/1956 24/09/2018 | Serial | 015 Last Visit: 24/09/2018 |
| Patient Name | Mr. ASHIS MODOK | Contact No | 9830779549 |
| Address | 20 N N ROY STREET | Age | 52.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 110/80 mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||