Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01730 | Date 29/10/2018 |
| Token No | SM/18-19/7104 19/01/2019 | Serial | 037 Last Visit: 07/03/2019 |
| Patient Name | Mr. DHRUB DAS | Contact No | 8017057792 |
| Address | 70, BLC MILL ROAD SERAMPORE | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||