Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05918 | Date 24/07/2019 |
| Token No | SM/19-20/7173 24/07/2019 | Serial | 015 Last Visit: 24/07/2019 |
| Patient Name | Mr. MD ISTIYAR | Contact No | 9051121592 |
| Address | CHATRA MUSALMAN PARA | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||