Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03674 | Date 18/02/2019 |
| Token No | SM/19-20/6400 13/07/2019 | Serial | 064 Last Visit: 13/07/2019 |
| Patient Name | Master ARYAN DAS | Contact No | 7044773658 |
| Address | CHATRA MUSALMAN PARA SHEWRAPHULI | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||