Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09628 | Date 21/05/2021 |
| Token No | SM/21-22/1589 21/05/2021 | Serial | 005 Last Visit: 21/05/2021 |
| Patient Name | Master SURAJIT SARDER | Contact No | 7044594501 |
| Address | SADGOPE PARA BHATTACHARJEE PARA SERAMPORE | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||