Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00314 | Date 10/08/2018 |
| Token No | SM/18-19/340 10/08/2018 | Serial | 028 Last Visit: 10/08/2018 |
| Patient Name | Mr. SUMIT RAJAK | Contact No | 9883119990 |
| Address | 1/Q GT ROAD SERAMPORE | Age | 16.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||