Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02676 | Date 24/12/2018 |
| Token No | SM/18-19/5723 24/12/2018 | Serial | 046 Last Visit: 24/12/2018 |
| Patient Name | Mr. SK RUMJAN | Contact No | 8479042235 |
| Address | CHATRA MUSALAMAN PARA | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||