Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01717 | Date 27/10/2018 |
| Token No | SM/18-19/3009 27/10/2018 | Serial | 058 Last Visit: 10/06/2020 |
| Patient Name | Mr. MD NABEULLA | Contact No | 9874876616 |
| Address | 21 CHATRA SUSALMAN PARA BY LANE | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||