Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03234 | Date 30/01/2019 |
| Token No | SM/18-19/7602 30/01/2019 | Serial | 032 Last Visit: 30/01/2019 |
| Patient Name | Mr. ASIT SOM | Contact No | 9836183459 |
| Address | 37/L CHATRA, DHARMA TALA | Age | 66 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||