Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 11067 | Date 28/05/2022 |
| Token No | SM/22-23/12999 28/05/2022 | Serial | 018 Last Visit: 28/05/2022 |
| Patient Name | Master MD. RAMJAN | Contact No | |
| Address | 25 CHATRA KANAIDEWAN TALA SERAMPORE | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||