Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03226 | Date 29/01/2019 |
| Token No | SM/18-19/7560 29/01/2019 | Serial | 053 Last Visit: 29/01/2019 |
| Patient Name | Master ADDYA CHATTERJEE | Contact No | 9748068816 |
| Address | 1/D DUTTA PARA LANE | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||