Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00758 | Date 28/08/2018 |
| Token No | SM/18-19/938 28/08/2018 | Serial | 008 Last Visit: 28/08/2018 |
| Patient Name | Mr. PETER PAL | Contact No | 8981219165 |
| Address | 16, RAJA K.L GOSWAMI STREET | Age | 30.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 159/98 mmHg | Weight | 85 KG |
| Pulse Rate | 100 / min | Height | cm BMI: inf |
| Diagnosis | |||