Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01528 | Date 05/10/2018 |
| Token No | SM/18-19/6231 04/01/2019 | Serial | 016 Last Visit: 30/04/2020 |
| Patient Name | Mr. SK SAMIM | Contact No | 8336808565 |
| Address | 23/1/A CHATRA KUMAR PARA LANE | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||