Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02379 | Date 06/12/2018 |
| Token No | SM/18-19/6633 10/01/2019 | Serial | 060 Last Visit: 10/01/2019 |
| Patient Name | Mr. SAUMODIP DAS | Contact No | 9432000596 |
| Address | 34/A RMC LAHIRI STREET SERAMPORE | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||