Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04758 | Date 18/04/2019 |
| Token No | SM/19-20/1122 18/04/2019 | Serial | 035 Last Visit: 18/04/2019 |
| Patient Name | Mr. GOURAB CHAKRABORTY | Contact No | 9339620741 |
| Address | 62 THAKUR DAS BABU LANE SERAMPORE | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||