Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01539 | Date 05/10/2018 |
| Token No | SM/18-19/2531 05/10/2018 | Serial | 052 Last Visit: 28/08/2019 |
| Patient Name | Mr. SK JABBER | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 12 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||