Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05243 | Date 27/05/2019 |
| Token No | SM/19-20/9089 26/08/2019 | Serial | 005 Last Visit: 16/09/2019 |
| Patient Name | Mr. SAID ALI | Contact No | 6289366469 |
| Address | 9 MUSALMAN PARA BYE LANE CHATRA SERAMPORE | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||