Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01732 | Date 29/10/2018 |
| Token No | SM/18-19/3032 29/10/2018 | Serial | 004 Last Visit: 29/10/2018 |
| Patient Name | Master MD RAJA | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 23 Month Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 8 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||