Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00519 | Date 17/08/2018 |
| Token No | SM/18-19/5315 15/12/2018 | Serial | 047 Last Visit: 08/01/2019 |
| Patient Name | Mr. MAJIBUL | Contact No | 9007755751 |
| Address | 4/A ARABINDA SARANI | Age | 40.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||