Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08011 | Date 03/04/2020 |
| Token No | SM/21-22/2995 08/07/2021 | Serial | 017 Last Visit: 23/08/2021 |
| Patient Name | Mr. MD.HAFIZ | Contact No | 9674107580 |
| Address | 18/1 CHATRA MUSALMAN PARA LANE SERAMPORE(M) | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||