Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06190 | Date 21/08/2019 |
| Token No | SM/19-20/8878 21/08/2019 | Serial | 040 Last Visit: 21/08/2019 |
| Patient Name | Mr. ROHIT RAM | Contact No | 8697040463 |
| Address | 10 M.G ROAD SERAMPORE | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||