Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00749 | Date 27/08/2018 |
| Token No | SM/18-19/7912 04/02/2019 | Serial | 008 Last Visit: 04/02/2019 |
| Patient Name | Master SK HASSAN | Contact No | |
| Address | 41 CHATRA MUSALMAN PARA | Age | 1.6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||