Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06978 | Date 25/11/2019 |
| Token No | SM/19-20/13912 25/11/2019 | Serial | 021 Last Visit: 25/11/2019 |
| Patient Name | Mr. SK SAHIM | Contact No | 6294631464 |
| Address | 14 CHATRA MUSALMAN PARA , SERAMPORE | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||