Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02795 | Date 02/01/2019 |
| Token No | SM/18-19/6163 02/01/2019 | Serial | 072 Last Visit: 02/01/2019 |
| Patient Name | Mr. SK SALAUDDIN | Contact No | 8820217073 |
| Address | 7/D AUROBINDO SARANI | Age | 29 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 77 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||