Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05629 | Date 29/06/2019 |
| Token No | SM/19-20/5647 29/06/2019 | Serial | 080 Last Visit: 29/06/2019 |
| Patient Name | Master MD AHMED | Contact No | |
| Address | 21 CHATRA MUSALMAN PARA | Age | 2 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||