Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06504 | Date 23/09/2019 |
| Token No | SM/19-20/10921 23/09/2019 | Serial | 048 Last Visit: 24/09/2019 |
| Patient Name | Mr. SRIJAN MAJUMDAR | Contact No | 9831874044 |
| Address | 25/1F ROY M C .LAHIRI STREET | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||