Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05392 | Date 11/06/2019 |
| Token No | SM/21-22/4450 26/08/2021 | Serial | 034 Last Visit: 26/08/2021 |
| Patient Name | Mr. MD SHARTAJ | Contact No | 8481989390 |
| Address | 21/C CHATRA MUSALMAN PARA BYE LANE SERAMPORE | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||