Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06553 | Date 26/09/2019 |
| Token No | SM/19-20/11186 26/09/2019 | Serial | 070 Last Visit: 26/09/2019 |
| Patient Name | Master SUBHAM ROY | Contact No | 9836579550 |
| Address | 39/A BARA BAGAN LANE | Age | 2 Y 2 M Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||