Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00603 | Date 21/08/2018 |
| Token No | SM/18-19/717 21/08/2018 | Serial | 015 Last Visit: 21/08/2018 |
| Patient Name | Mr. SAHAM SINGH RAY | Contact No | 9231900312 |
| Address | 12/C BYE SERAMPORE | Age | 7.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||