Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03996 | Date 05/03/2019 |
| Token No | SM/19-20/8883 21/08/2019 | Serial | 045 Last Visit: 18/11/2019 |
| Patient Name | Mr. RANIT PAL | Contact No | 8777838883 |
| Address | 36 CHATRA KUMAR PARA SERAMPORE | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 72 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||