Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02992 | Date 14/01/2019 |
| Token No | SM/18-19/6774 14/01/2019 | Serial | 065 Last Visit: 10/11/2020 |
| Patient Name | Mr. AYUB ALI LASKAR | Contact No | 9051672355 |
| Address | 18 MUSALMAN PARA, CHATRA SERAMPORE | Age | 5.8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||