Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03811 | Date 22/02/2019 |
| Token No | SM/18-19/10403 11/03/2019 | Serial | 112 Last Visit: 11/03/2019 |
| Patient Name | Mr. SK SANI | Contact No | 8231879979 |
| Address | CHATRA MUSALMAN PARA | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||