Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04191 | Date 13/03/2019 |
| Token No | SM/18-19/10479 13/03/2019 | Serial | 006 Last Visit: 13/03/2019 |
| Patient Name | Master SK IMTAJ | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 5 MONTH Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||