Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03892 | Date 27/02/2019 |
| Token No | SM/18-19/9533 27/02/2019 | Serial | 022 Last Visit: 27/02/2019 |
| Patient Name | Mr. SK ABDUL KASHEM | Contact No | 9903680612 |
| Address | 27/C CHATRA MUSALMAN PARA BYE LANE SERAMPORE | Age | 6 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||