Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01886 | Date 03/11/2018 |
| Token No | SM/19-20/6875 19/07/2019 | Serial | 065 Last Visit: 04/09/2021 |
| Patient Name | Mr. SK NASIM | Contact No | 9831277112 |
| Address | CHATRA MUSALMAN PARA SERAMPORE | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||