Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05213 | Date 23/05/2019 |
| Token No | SM/19-20/3313 23/05/2019 | Serial | 061 Last Visit: 23/05/2019 |
| Patient Name | Mr. NOOR ISLAM | Contact No | 8478988101 |
| Address | 89C MALLICK PARA | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||