Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01075 | Date 12/09/2018 |
| Token No | SM/18-19/1560 12/09/2018 | Serial | 026 Last Visit: 12/09/2018 |
| Patient Name | Master SK SAMIR | Contact No | 6290668927 |
| Address | CHATRA MUSALMANPARA | Age | 5.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||