Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02082 | Date 22/11/2018 |
| Token No | SM/18-19/4032 22/11/2018 | Serial | 027 Last Visit: 22/11/2018 |
| Patient Name | Mr. MD KALIM | Contact No | 7890681416 |
| Address | CHATRA MUSALMAN PARA | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||