Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01596 | Date 10/10/2018 |
| Token No | SM/18-19/2684 10/10/2018 | Serial | 009 Last Visit: 10/10/2018 |
| Patient Name | Mr. SUSANTA DAS | Contact No | |
| Address | KATOYA | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 90/60 mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||