Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05863 | Date 20/07/2019 |
| Token No | SM/19-20/6922 20/07/2019 | Serial | 025 Last Visit: 20/07/2019 |
| Patient Name | Mr. SK SIRAJUL | Contact No | 9836859295 |
| Address | 28 CHATRA MUSALMAN PARA | Age | 39 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||