Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10968 | Date 28/04/2022 |
| Token No | SM/22-23/12058 28/04/2022 | Serial | 018 Last Visit: 28/04/2022 |
| Patient Name | Master SK. HANIF | Contact No | 9062135085 |
| Address | 36/A CHATRA MUSALMAN PARA BYE LANE SEORAPHULLY SERAMPORE(M) | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||