Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03046 | Date 17/01/2019 |
| Token No | SM/18-19/6960 17/01/2019 | Serial | 040 Last Visit: 25/07/2025 |
| Patient Name | Mr. ALI ANSARI | Contact No | 8420943784 |
| Address | 12 GOPINATH SAHA STREET | Age | 15 Years,5 Months,17 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||