Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01718 | Date 27/10/2018 |
| Token No | SM/18-19/3010 27/10/2018 | Serial | 059 Last Visit: 27/10/2018 |
| Patient Name | Mr. MD HABIB | Contact No | 9874876616 |
| Address | 21 CHATRA MUSALMAN PARA BY LANE | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||