Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07011 | Date 29/11/2019 |
| Token No | SM/19-20/14282 29/11/2019 | Serial | 051 Last Visit: 29/11/2019 |
| Patient Name | Master SK FARHAN | Contact No | 7890676273 |
| Address | 4 CHATRA MUSALMAN PARA SERAMPORE | Age | 3 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||