Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01457 | Date 01/10/2018 |
| Token No | SM/18-19/2477 04/10/2018 | Serial | 075 Last Visit: 04/10/2018 |
| Patient Name | Master SK RASHIDUDDIN | Contact No | 8479954056 |
| Address | 12, CHATRA MUSALMAN PARA | Age | 1 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||