Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05320 | Date 03/06/2019 |
| Token No | SM/19-20/3894 03/06/2019 | Serial | 017 Last Visit: 03/06/2019 |
| Patient Name | Master SK FARHAN | Contact No | 6289026223 |
| Address | 16 T.C GOSWAMI STREET | Age | 2 Y 6 M Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||