Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05441 | Date 14/06/2019 |
| Token No | SM/19-20/4617 14/06/2019 | Serial | 092 Last Visit: 14/06/2019 |
| Patient Name | Mr. SK ISRAIL | Contact No | 9062271985 |
| Address | MALLIK PARA,CHILE KHALA ROAD | Age | 57 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||