Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01462 | Date 01/10/2018 |
| Token No | SM/18-19/2332 01/10/2018 | Serial | 052 Last Visit: 01/10/2018 |
| Patient Name | Mr. SK. NAJIR | Contact No | |
| Address | 10/D CHATRA MUSALMAN PRA | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||