Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06788 | Date 05/11/2019 |
| Token No | SM/19-20/12660 05/11/2019 | Serial | 034 Last Visit: 05/11/2019 |
| Patient Name | Mr. MD FARHAN | Contact No | 7003857249 |
| Address | 32 T.C. GOSWAMI STREET | Age | 11 Y Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||