Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02841 | Date 05/01/2019 |
| Token No | SM/18-19/6732 14/01/2019 | Serial | 023 Last Visit: 14/01/2019 |
| Patient Name | Mr. SK ALIM | Contact No | 9831277112 |
| Address | 37 J CHATRA MUSALMAN PARA | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 93 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||