Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06691 | Date 19/10/2019 |
| Token No | SM/19-20/12061 19/10/2019 | Serial | 010 Last Visit: 05/10/2020 |
| Patient Name | Mr. SK NAJIBUL | Contact No | 8479051470 |
| Address | 5/A MUSALMAN PARA BYE LANE SERAMPORE | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||