Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02906 | Date 08/01/2019 |
| Token No | SM/18-19/6500 08/01/2019 | Serial | 054 Last Visit: 08/01/2019 |
| Patient Name | Mr. SK SABIR | Contact No | 7449881681 |
| Address | CHATRA KANAI DAUN TALA | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||