Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03925 | Date 01/03/2019 |
| Token No | SM/18-19/9640 01/03/2019 | Serial | 015 Last Visit: 01/03/2019 |
| Patient Name | Mr. MD SAMIM | Contact No | 7044611156 |
| Address | 7 ARABINDO SWARANI | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||