Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06141 | Date 19/08/2019 |
| Token No | SM/19-20/8570 19/08/2019 | Serial | 024 Last Visit: 19/08/2019 |
| Patient Name | Mr. SK AZAD | Contact No | 7278041759 |
| Address | 36/A CHATRA , MUSALMAN PARA BYE LANE | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||