Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00574 | Date 20/08/2018 |
| Token No | SM/18-19/8570 13/02/2019 | Serial | 037 Last Visit: 28/03/2019 |
| Patient Name | Mr. ARPAN BAG | Contact No | 8777013228 |
| Address | 162/A BAGER BAGAN TELI PARA CHATRA | Age | 19.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||