Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01107 | Date 13/09/2018 |
| Token No | SM/18-19/4930 08/12/2018 | Serial | 057 Last Visit: 09/04/2019 |
| Patient Name | Mr. SK MOTIN | Contact No | 8820186193 |
| Address | 5/B CHATRA MUSALMAN PARA | Age | 75 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||