Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01645 | Date 12/10/2018 |
| Token No | SM/18-19/2820 12/10/2018 | Serial | 027 Last Visit: 12/10/2018 |
| Patient Name | Mr. DEBAN DAS | Contact No | |
| Address | CHATRA LANKER BAGAN,CHAT CHASHI PARA | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 160/80 mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||