Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03836 | Date 23/02/2019 |
| Token No | SM/18-19/9365 23/02/2019 | Serial | 051 Last Visit: 23/02/2019 |
| Patient Name | Mr. AKASH RAM | Contact No | 9875437961 |
| Address | 13 N.N ROY STREET SERAMPORE | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||