Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02291 | Date 03/12/2018 |
| Token No | SM/18-19/10294 11/03/2019 | Serial | 003 Last Visit: 25/03/2019 |
| Patient Name | Mr. MD MAKSUD | Contact No | |
| Address | SHEORAPHULY | Age | 83 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||