Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06533 | Date 25/09/2019 |
| Token No | SM/19-20/20585 01/04/2020 | Serial | 007 Last Visit: 01/04/2020 |
| Patient Name | Master SK MOJAMMAL | Contact No | 9903642175 |
| Address | 27/C CHATRA,MUSALMAN PARA BEY LANE | Age | 4 Y 6 M Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||