Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08672 | Date 26/08/2020 |
| Token No | SM/19-20/25208 26/08/2020 | Serial | 018 Last Visit: 26/08/2020 |
| Patient Name | Mr. SK GULSAD | Contact No | 9874770573 |
| Address | 7 ARBINDA SARANI SERAMPORE | Age | 5 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||