Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02431 | Date 10/12/2018 |
| Token No | SM/18-19/4957 10/12/2018 | Serial | 005 Last Visit: 10/12/2018 |
| Patient Name | Mr. ROGHUNATH SOM | Contact No | 9051820560 |
| Address | 121 CHATRA BARUI PARA LANE | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 150/80 mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||