Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02876 | Date 07/01/2019 |
| Token No | SM/18-19/6418 07/01/2019 | Serial | 072 Last Visit: 07/01/2019 |
| Patient Name | Mr. SK FARUK | Contact No | 9830953893 |
| Address | 23/A MIYAJAN DARJI LANE | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||