Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01791 | Date 30/10/2018 |
| Token No | SM/18-19/5115 12/12/2018 | Serial | 029 Last Visit: 16/12/2019 |
| Patient Name | Mr. SK ASGAR | Contact No | 9143327399 |
| Address | CHATRA MUSALMAN PARA | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||