Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02022 | Date 19/11/2018 |
| Token No | SM/18-19/8165 06/02/2019 | Serial | 059 Last Visit: 06/02/2019 |
| Patient Name | Master REHAN ALI | Contact No | 9088268622 |
| Address | 7B CHATRA MUSALMAN PARA BY LANE | Age | 1 Y 2 M Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||