Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02188 | Date 28/11/2018 |
| Token No | SM/18-19/4330 28/11/2018 | Serial | 062 Last Visit: 29/06/2019 |
| Patient Name | Mr. MD NAUSAD | Contact No | 8697619357 |
| Address | CHATRA MUSALMAN PARA | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||