Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 01817 | Date 01/11/2018 |
| Token No | SM/18-19/3263 01/11/2018 | Serial | 012 Last Visit: 01/11/2018 |
| Patient Name | Mr. SOUBHIK DAS | Contact No | 9051099468 |
| Address | 3/44 MAHESH COLLNEY SERAMPORE | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||