Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05053 | Date 10/05/2019 |
| Token No | SM/19-20/2413 10/05/2019 | Serial | 010 Last Visit: 10/05/2019 |
| Patient Name | Mr. MD SAMSAD | Contact No | 6290893151 |
| Address | 14 BAZAR BYE LANE SERAMPORE | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||