Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05201 | Date 22/05/2019 |
| Token No | SM/19-20/3233 22/05/2019 | Serial | 074 Last Visit: 22/05/2019 |
| Patient Name | Mr. MD REHAN | Contact No | |
| Address | CHATRA MUSALAMAN PARA | Age | 3.6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||