Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02566 | Date 17/12/2018 |
| Token No | SM/18-19/5383 17/12/2018 | Serial | 064 Last Visit: 09/03/2019 |
| Patient Name | Mr. SWAPAN KUMAR ROY | Contact No | |
| Address | CHATRA, SABUJ SANGHO CLUB | Age | 71 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 140/100 mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||