Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02476 | Date 12/12/2018 |
| Token No | SM/18-19/5103 12/12/2018 | Serial | 017 Last Visit: 08/04/2019 |
| Patient Name | Mr. MD SURAMAN | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||