Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03276 | Date 01/02/2019 |
| Token No | SM/18-19/7758 01/02/2019 | Serial | 034 Last Visit: 01/02/2019 |
| Patient Name | Mr. SK NUR ISLAM | Contact No | 7890481284 |
| Address | 10 CHATRA MUSALMAN PARA | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||