Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01487 | Date 03/10/2018 |
| Token No | SM/18-19/2402 03/10/2018 | Serial | 057 Last Visit: 25/09/2019 |
| Patient Name | Mr. RAYEN DAS | Contact No | 9163517709 |
| Address | 25A CHATRA DHARMOTALA LANE SERAMPORE | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||