Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07081 | Date 05/12/2019 |
| Token No | SM/19-20/14715 05/12/2019 | Serial | 043 Last Visit: 05/12/2019 |
| Patient Name | Master RAJIB DOLUI | Contact No | 7449656220 |
| Address | KANAI DEWAN TALA LANE SERAMPORE | Age | 4.11YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||