Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01391 | Date 27/09/2018 |
| Token No | SM/18-19/2165 27/09/2018 | Serial | 046 Last Visit: 11/03/2020 |
| Patient Name | Mr. SK ROHIT | Contact No | |
| Address | 20, CHATRA KUMAR PARA SERAMPORE | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||