Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02342 | Date 04/12/2018 |
| Token No | SM/18-19/4922 08/12/2018 | Serial | 049 Last Visit: 08/12/2018 |
| Patient Name | Master SK SAHID | Contact No | |
| Address | 5/A/2 CHATRA MUSALMAN PARA | Age | 2 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||