Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06620 | Date 14/10/2019 |
| Token No | SM/19-20/12517 31/10/2019 | Serial | 038 Last Visit: 06/11/2019 |
| Patient Name | Mr. SK SHAHRUKH | Contact No | 9038164940 |
| Address | 29/A CHATRA MUSALMAN PARA,SHEORAPHULI | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||