Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02560 | Date 17/12/2018 |
| Token No | SM/18-19/5413 18/12/2018 | Serial | 022 Last Visit: 18/12/2018 |
| Patient Name | Mr. ARNAB BENERJEE | Contact No | 9051360850 |
| Address | 47/1 N P CHAKRABORTY LANE | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||