Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06264 | Date 29/08/2019 |
| Token No | SM/19-20/9390 29/08/2019 | Serial | 031 Last Visit: 29/08/2019 |
| Patient Name | Mr. MD SIYAD | Contact No | 9748252282 |
| Address | 21 A MUSALMAN PARA BYE LANE | Age | 33 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||