Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05731 | Date 11/07/2019 |
| Token No | SM/19-20/6269 11/07/2019 | Serial | 019 Last Visit: 11/07/2019 |
| Patient Name | Mr. SK SAIDUL | Contact No | 8478953945 |
| Address | 28 CHILAKHLA ROAD,MALLICK PARA | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||