Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06666 | Date 16/10/2019 |
| Token No | SM/19-20/11885 16/10/2019 | Serial | 103 Last Visit: 16/10/2019 |
| Patient Name | Mr. SK ASIF | Contact No | 8479953925 |
| Address | 4/A CHATRA MUSALMAN PARA LANE | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||