Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07040 | Date 02/12/2019 |
| Token No | SM/19-20/14490 02/12/2019 | Serial | 083 Last Visit: 02/12/2019 |
| Patient Name | Mr. SK SUJAUDDIN | Contact No | 8777869445 |
| Address | 36/A MUSALMAN PARA BYE LANE CHATRA SERAMPORE | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||