Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02341 | Date 04/12/2018 |
| Token No | SM/18-19/4674 04/12/2018 | Serial | 060 Last Visit: 04/12/2018 |
| Patient Name | Master SK SAJID | Contact No | |
| Address | 5/A/2 CHATRA MUSALMAN PARA | Age | 5 M Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||