Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03665 | Date 18/02/2019 |
| Token No | SM/18-19/8928 18/02/2019 | Serial | 101 Last Visit: 18/02/2019 |
| Patient Name | Mr. SK ISMAIL | Contact No | 9831481291 |
| Address | CHATRA MUSALMAN PARA | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||