Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00620 | Date 21/08/2018 |
| Token No | SM/18-19/2924 26/10/2018 | Serial | 038 Last Visit: 09/01/2019 |
| Patient Name | Mr. NIRMAL DHUL | Contact No | |
| Address | BAGER BAGAN TELI PARA | Age | 61 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/70 mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||