Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 15928 | Date 23/08/2025 |
| Token No | SM/25-26/5179 23/08/2025 | Serial | 059 Last Visit: 23/08/2025 |
| Patient Name | Mr. MD BASIR | Contact No | 8777614942 |
| Address | 21 MUSALMAN PARA ROAD , SERAMPORE | Age | 14 Years,7 Months,21 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||