Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02827 | Date 04/01/2019 |
| Token No | SM/19-20/14368 30/11/2019 | Serial | 042 Last Visit: 30/11/2019 |
| Patient Name | Master SK HOSSAIN ALI | Contact No | |
| Address | BARO BELUR KAL TALA | Age | 2 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||