Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09930 | Date 11/08/2021 |
| Token No | SM/21-22/3960 11/08/2021 | Serial | 023 Last Visit: 11/08/2021 |
| Patient Name | Mr. M.D ROMJAN ALI | Contact No | 7439234459 |
| Address | 21/C CHATRA MUSHALMAN PARA SERAMPORE | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||