Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05966 | Date 26/07/2019 |
| Token No | SM/19-20/7376 26/07/2019 | Serial | 045 Last Visit: 26/07/2019 |
| Patient Name | Master MD ISTIFA | Contact No | 9748249014 |
| Address | 33/A CHATRA MUSALMAN PARA | Age | 5 MONTH Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||