Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04924 | Date 26/04/2019 |
| Token No | SM/19-20/1721 26/04/2019 | Serial | 033 Last Visit: 26/04/2019 |
| Patient Name | Baby FALAK QURASHI | Contact No | 7890725671 |
| Address | 88/E MD LANE MALLIK PARA SERAMPORE | Age | 3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||