Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 10014 | Date 01/09/2021 |
| Token No | SM/21-22/4607 01/09/2021 | Serial | 005 Last Visit: 01/09/2021 |
| Patient Name | Mr. MD. JASIM | Contact No | 9038840557 |
| Address | 36/A/1 MUSHALMAN PARA LANE SERAMPORE | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||