Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02867 | Date 07/01/2019 |
| Token No | SM/18-19/6399 07/01/2019 | Serial | 053 Last Visit: 06/07/2019 |
| Patient Name | Master SK RAHAMAN | Contact No | |
| Address | 23/A MEYAJAN DARJI LANE,MALLICK PARA | Age | 5 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||