Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06098 | Date 09/08/2019 |
| Token No | SM/19-20/8266 09/08/2019 | Serial | 073 Last Visit: 09/08/2019 |
| Patient Name | Mr. SK SAMIR | Contact No | 9330082321 |
| Address | 7 ARBINDA SARANI CHATRA SERAMPORE | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||