Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06882 | Date 16/11/2019 |
| Token No | SM/19-20/13360 16/11/2019 | Serial | 020 Last Visit: 16/11/2019 |
| Patient Name | Master MD ISHAN | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||