Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03644 | Date 18/02/2019 |
| Token No | SM/18-19/8882 18/02/2019 | Serial | 055 Last Visit: 18/02/2019 |
| Patient Name | Mr. SK REZWAL | Contact No | 6289257473 |
| Address | 23, MALLIK PARA SERAMPORE | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||