Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01377 | Date 27/09/2018 |
| Token No | SM/18-19/2819 12/10/2018 | Serial | 026 Last Visit: 27/11/2018 |
| Patient Name | Mr. BULTU GUIN | Contact No | 9836125054 |
| Address | 90/2 CHATRA BARUI PARA | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | 180/95 / min | Height | cm BMI: nan |
| Diagnosis | |||