Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05674 | Date 05/07/2019 |
| Token No | SM/19-20/5920 05/07/2019 | Serial | 083 Last Visit: 05/07/2019 |
| Patient Name | Mr. AMAN JAISWARA | Contact No | 9330152600 |
| Address | 18 NO RABINDRA BHABAN ROAD SERAMPORE | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||