Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05799 | Date 16/07/2019 |
| Token No | SM/19-20/6600 16/07/2019 | Serial | 048 Last Visit: 16/07/2019 |
| Patient Name | Mr. SK AZAD | Contact No | 9143327399 |
| Address | SEORAPHULI ,CHATRA MUSALMAN PARA, | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||