Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06958 | Date 22/11/2019 |
| Token No | SM/19-20/13799 22/11/2019 | Serial | 048 Last Visit: 23/11/2019 |
| Patient Name | Master ATHARAB SHAW | Contact No | 7003222720 |
| Address | 57 K.M BHATTCHARJEE STREET SERAMPORE | Age | 3 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||