Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06917 | Date 19/11/2019 |
| Token No | SM/19-20/13576 19/11/2019 | Serial | 073 Last Visit: 19/11/2019 |
| Patient Name | Mr. SK MARIUDIN | Contact No | |
| Address | CHATRA MUSALMAN PARA SERAMPORE.. | Age | 6 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||