Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06718 | Date 21/10/2019 |
| Token No | SM/19-20/12173 21/10/2019 | Serial | 070 Last Visit: 21/10/2019 |
| Patient Name | Master GULAMGASH | Contact No | 8481010783 |
| Address | N.N RAY STREET SERAMPORE | Age | 4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||