Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01987 | Date 15/11/2018 |
| Token No | SM/18-19/3746 15/11/2018 | Serial | 041 Last Visit: 15/11/2018 |
| Patient Name | Mr. ASHIS MAJHI | Contact No | |
| Address | 12 ROY GHAT LANE | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||