Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03164 | Date 24/01/2019 |
| Token No | SM/18-19/7392 24/01/2019 | Serial | 079 Last Visit: 30/01/2019 |
| Patient Name | Mr. SAN MOHAMMAD | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||