Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05999 | Date 29/07/2019 |
| Token No | SM/19-20/7540 29/07/2019 | Serial | 076 Last Visit: 29/07/2019 |
| Patient Name | Master SK AAYAN | Contact No | 8820407008 |
| Address | 19C CHATRA KUMAR PARA 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 | |||