Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06555 | Date 26/09/2019 |
| Token No | SM/19-20/11188 26/09/2019 | Serial | 072 Last Visit: 26/09/2019 |
| Patient Name | Mr. GULAMOHIUDDIN | Contact No | 8584963081 |
| Address | CHATRA MUSALMAN PARA | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||