Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05585 | Date 26/06/2019 |
| Token No | SM/19-20/5387 26/06/2019 | Serial | 051 Last Visit: 26/06/2019 |
| Patient Name | Mr. SONALI JANA | Contact No | |
| Address | BAGER BAGAN TELIPARA CHATRA SEORAPHULI | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||