Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07862 | Date 19/03/2020 |
| Token No | SM/19-20/19959 19/03/2020 | Serial | 062 Last Visit: 19/03/2020 |
| Patient Name | Mr. SAYAN SRIWASTAV | Contact No | 9330964169 |
| Address | DAKSHIN RAJYADHARPUR, SARDARPARA , SERAMPORE MALLICKPARA | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||