Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01959 | Date 14/11/2018 |
| Token No | SM/18-19/3673 14/11/2018 | Serial | 062 Last Visit: 18/03/2020 |
| Patient Name | Mr. SK JABIR ALI | Contact No | 6291009107 |
| Address | 32 MUSALMAN PARA BYE LANE | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||