Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 10364 | Date 30/11/2021 |
| Token No | SM/22-23/17091 24/09/2022 | Serial | 020 Last Visit: 12/12/2022 |
| Patient Name | Mr. SHIVAM BARMA | Contact No | 9062375163 |
| Address | 11A, DOCTOR BAGAN LANE SERAMPORE | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||