Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01703 | Date 27/10/2018 |
| Token No | SM/18-19/2988 27/10/2018 | Serial | 037 Last Visit: 27/10/2018 |
| Patient Name | Mr. MASHUDAR RAHMAN | Contact No | 9830768577 |
| Address | 3 CHATRA BARIM GHAOSH LANE | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||