Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05111 | Date 15/05/2019 |
| Token No | SM/19-20/3654 29/05/2019 | Serial | 021 Last Visit: 17/07/2019 |
| Patient Name | Mr. AMIR RAHMAN | Contact No | 9051217654 |
| Address | CHATRA MUSALMAN PARA | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||