Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01996 | Date 16/11/2018 |
| Token No | SM/19-20/3187 22/05/2019 | Serial | 028 Last Visit: 23/12/2019 |
| Patient Name | Mr. SK MUKSED ALI | Contact No | 9874463025 |
| Address | 50 CHATRA MUSALMAN PARA ROAD | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||