Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04151 | Date 11/03/2019 |
| Token No | SM/18-19/10342 11/03/2019 | Serial | 051 Last Visit: 11/03/2019 |
| Patient Name | Mr. SUROJIT SAHA | Contact No | 8017728233 |
| Address | 20 RAY GHAT LANE SERAMPORE | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||