Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01887 | Date 03/11/2018 |
| Token No | SM/18-19/6329 05/01/2019 | Serial | 044 Last Visit: 05/01/2019 |
| Patient Name | Mr. SK JASIM | Contact No | 9831277112 |
| Address | 37J CHATRA MUSALMAN PARA LANE | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||