Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03170 | Date 24/01/2019 |
| Token No | SM/18-19/7405 24/01/2019 | Serial | 092 Last Visit: 24/01/2019 |
| Patient Name | Mr. MD ISRAIL | Contact No | 9874876616 |
| Address | 21 CHATRA MUSALMAN PARA BY LANE | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||