Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01970 | Date 14/11/2018 |
| Token No | SM/18-19/3701 14/11/2018 | Serial | 090 Last Visit: 20/12/2018 |
| Patient Name | Mr. SK SAJAHAN | Contact No | 8961137245 |
| Address | 17CHATRA ARABINDA SWARANI | Age | 37 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||