Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08344 | Date 12/06/2020 |
| Token No | SM/19-20/23037 12/06/2020 | Serial | 043 Last Visit: 12/06/2020 |
| Patient Name | Mr. MD AYAN | Contact No | |
| Address | CHATRA MUSALMAN PARA BYE LANE | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||