Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04158 | Date 11/03/2019 |
| Token No | SM/18-19/10354 11/03/2019 | Serial | 063 Last Visit: 11/03/2019 |
| Patient Name | Mr. AKASH DALAL | Contact No | 9874875953 |
| Address | CHATRA TETULTALA SERAMPORE | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||