Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01953 | Date 14/11/2018 |
| Token No | SM/18-19/3653 14/11/2018 | Serial | 042 Last Visit: 01/12/2018 |
| Patient Name | Mr. T K SOM | Contact No | 9818543498 |
| Address | 13 CHATRA DUTTA PARA | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 170/90 mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||