Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 03080 | Date 19/01/2019 |
| Token No | SM/18-19/7071 19/01/2019 | Serial | 004 Last Visit: 19/01/2019 |
| Patient Name | Mr. GAYAMOY SIULY | Contact No | 7890662724 |
| Address | 5 TARAPUKUR LANE | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 150/90 mmHg | Weight | 83 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||