Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00611 | Date 21/08/2018 |
| Token No | SM/18-19/728 21/08/2018 | Serial | 026 Last Visit: 21/08/2018 |
| Patient Name | Mr. MONU SINGH | Contact No | |
| Address | G.T. ROAD, BAIDYABATI M | Age | 22.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||