Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06532 | Date 24/09/2019 |
| Token No | SM/19-20/11057 24/09/2019 | Serial | 075 Last Visit: 24/09/2019 |
| Patient Name | Mr. SK LALU | Contact No | 8697619217 |
| Address | 44 CHATRA MUSALMAN PARA BEY LANE | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||