Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01895 | Date 05/11/2018 |
| Token No | SM/18-19/3899 19/11/2018 | Serial | 066 Last Visit: 07/07/2020 |
| Patient Name | Mr. SK YAKUB ALI | Contact No | 7044628913 |
| Address | 33 CHATRA MUSALMAN PARA | Age | 83 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||