Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 00972 | Date 07/09/2018 |
| Token No | SM/18-19/1340 07/09/2018 | Serial | 012 Last Visit: 31/10/2018 |
| Patient Name | Mr. RAJU SARKAR | Contact No | 8013175966 |
| Address | PACHU BAJAR BARAL BAGAN LANE SERAMPORE | Age | 8.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||