Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01048 | Date 11/09/2018 |
| Token No | SM/18-19/1512 11/09/2018 | Serial | 042 Last Visit: 11/09/2018 |
| Patient Name | Mr. SK ARMAN | Contact No | 9088182394 |
| Address | CHATRA MUSALMAN PARA | Age | 8.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||