Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 07160 | Date 16/12/2019 |
| Token No | SM/19-20/15376 16/12/2019 | Serial | 040 Last Visit: 16/12/2019 |
| Patient Name | Mr. AYUSH SHA | Contact No | 6290034088 |
| Address | 4 KUMAR PATTI LANE SERAMPORE | Age | 10 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||