Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05300 | Date 30/05/2019 |
| Token No | SM/19-20/3738 30/05/2019 | Serial | 031 Last Visit: 30/05/2019 |
| Patient Name | Mr. SOUMOJIT GIRI | Contact No | 7003008618 |
| Address | 13 N.N RAY STREET SERAMPORE | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||