Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01717 | Date 27/10/2018 |
| Token No | SM/19-20/22950 10/06/2020 | Serial | 035 Last Visit: 10/06/2020 |
| Patient Name | Mr. MD NABEULLA | Contact No | 9874876616 |
| Address | 21 CHATRA SUSALMAN PARA BY LANE | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||