Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06489 | Date 20/09/2019 |
| Token No | SM/19-20/10786 20/09/2019 | Serial | 077 Last Visit: 20/09/2019 |
| Patient Name | Mr. SK AMIN | Contact No | 9875427846 |
| Address | 20 KANAI DEOWAN TALA LANE SERAMPORE | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||