Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09658 | Date 29/05/2021 |
| Token No | SM/21-22/1772 29/05/2021 | Serial | 011 Last Visit: 08/06/2021 |
| Patient Name | Mr. SK SIRAJ | Contact No | 8478975006 |
| Address | 1, MUSALMAN PARA BY LANE | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||