Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09242 | Date 03/02/2021 |
| Token No | SM/20-21/30060 03/02/2021 | Serial | 012 Last Visit: 03/02/2021 |
| Patient Name | Mr. MD HASIB KAZI | Contact No | 9143125757 |
| Address | 53 CHATRA MUSALMAN PARA ROAD SERAMPORE | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||