Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05198 | Date 22/05/2019 |
| Token No | SM/19-20/3224 22/05/2019 | Serial | 065 Last Visit: 22/05/2019 |
| Patient Name | Mr. ADRIJA DAS | Contact No | |
| Address | 20/D BARO BAGAN LANE SERAMPORE | Age | 2.6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||