Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05871 | Date 20/07/2019 |
| Token No | SM/19-20/6968 20/07/2019 | Serial | 071 Last Visit: 20/07/2019 |
| Patient Name | Mr. MD NAOSAD | Contact No | |
| Address | 57 N. N. ROY STREET | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||