Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01956 | Date 14/11/2018 |
| Token No | SM/18-19/3661 14/11/2018 | Serial | 050 Last Visit: 14/11/2018 |
| Patient Name | Mr. IRFAN ISLAM | Contact No | 8101002766 |
| Address | CHATRA KUMAR PARA | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||