Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01604 | Date 10/10/2018 |
| Token No | SM/18-19/2710 10/10/2018 | Serial | 035 Last Visit: 10/10/2018 |
| Patient Name | Master SK ABDUL KASYAM | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 5 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||