Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07112 | Date 09/12/2019 |
| Token No | SM/19-20/14947 09/12/2019 | Serial | 057 Last Visit: 09/12/2019 |
| Patient Name | Mr. SK JIYARUL RAHAMAN | Contact No | 9143655009 |
| Address | 21 KANAI DEWAN TALA BYE LANE | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||