Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04262 | Date 16/03/2019 |
| Token No | SM/19-20/18628 25/02/2020 | Serial | 028 Last Visit: 25/02/2020 |
| Patient Name | Master SK SOHEB | Contact No | 7890681705 |
| Address | 4 CHATRA MUSALMAN PARA BYE LANE, SERAMPORE | Age | 4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||