Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02462 | Date 11/12/2018 |
| Token No | SM/18-19/5045 11/12/2018 | Serial | 025 Last Visit: 11/12/2018 |
| Patient Name | Mr. SARAFAT ALI MALLICK | Contact No | 7003757532 |
| Address | CHATRA MUSALMAN PARA | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||