Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05311 | Date 31/05/2019 |
| Token No | SM/19-20/3793 31/05/2019 | Serial | 037 Last Visit: 31/05/2019 |
| Patient Name | Mr. ARSHAD ALAM | Contact No | 9903943802 |
| Address | 34 MUSALMAN PARA LANE SERAMPORE | Age | 4.6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||