Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02282 | Date 01/12/2018 |
| Token No | SM/18-19/4529 01/12/2018 | Serial | 056 Last Visit: 01/12/2018 |
| Patient Name | Mr. SK KURBAN | Contact No | 7044785761 |
| Address | 8 CHATRA BAJAR ROAD | Age | 32 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||