Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06811 | Date 07/11/2019 |
| Token No | SM/19-20/12851 07/11/2019 | Serial | 022 Last Visit: 07/11/2019 |
| Patient Name | Master SK NIJA MUDDIN | Contact No | 8777869445 |
| Address | 36/A MUSALMAN PARA BYE LANE | Age | 5 Months Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||