Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05762 | Date 13/07/2019 |
| Token No | SM/19-20/6440 13/07/2019 | Serial | 104 Last Visit: 28/08/2025 |
| Patient Name | Master MD SAMIR | Contact No | 7998883472 |
| Address | 19NO MUSALMANPARA /LANE PIARAPUR(P)SHEORAPHULI | Age | 10 Years,3 Months,21 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||