Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02255 | Date 01/12/2018 |
| Token No | SM/18-19/4478 01/12/2018 | Serial | 005 Last Visit: 01/12/2018 |
| Patient Name | Mr. BIKRAM BHERA | Contact No | 9804028259 |
| Address | 132, N.S AVENUE SERAMPORE | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||