Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05700 | Date 08/07/2019 |
| Token No | SM/19-20/6075 08/07/2019 | Serial | 048 Last Visit: 08/07/2019 |
| Patient Name | Mr. SAMIULLA LAASKAR | Contact No | 8926679534 |
| Address | 18CHATRA MUSALMANPARA | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||