Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10758 | Date 08/03/2022 |
| Token No | SM/21-22/10581 08/03/2022 | Serial | 006 Last Visit: 15/06/2022 |
| Patient Name | Master SK AMIN | Contact No | 8595302405 |
| Address | 20 KANAI DEOWAN TALA SERAMPORE (M) | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||