Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 11425 | Date 12/08/2022 |
| Token No | SM/22-23/15642 12/08/2022 | Serial | 012 Last Visit: 12/08/2022 |
| Patient Name | Mr. MD MUSTAFA | Contact No | 9748249014 |
| Address | 12 MUSALMAN PARA BYE LANE CHATRA SERAMPORE | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||