Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08176 | Date 30/04/2020 |
| Token No | SM/19-20/21758 30/04/2020 | Serial | 042 Last Visit: 30/04/2020 |
| Patient Name | Mr. SAYED ASHRAF GAHANGIR ALI | Contact No | 6291017559 |
| Address | 26/A KANAI DEWAN TALA LANE,SHEORAPHULI. | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||