Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02559 | Date 17/12/2018 |
| Token No | SM/19-20/8441 16/08/2019 | Serial | 024 Last Visit: 20/02/2020 |
| Patient Name | Mr. SK AMIM | Contact No | 9143327399 |
| Address | 7 CHATRA MUSALMAN PARA | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||