Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07078 | Date 05/12/2019 |
| Token No | SM/19-20/14710 05/12/2019 | Serial | 038 Last Visit: 05/12/2019 |
| Patient Name | Master SK SALMAN ALI | Contact No | 9681676700 |
| Address | 19/C, KUMAR PARA LANE SERAMPORE | Age | 3.6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||