Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06709 | Date 21/10/2019 |
| Token No | SM/19-20/12148 21/10/2019 | Serial | 045 Last Visit: 21/10/2019 |
| Patient Name | Mr. SUBHAM DAS | Contact No | 9477090239 |
| Address | 34/A THAKUR DAS BABU LANE SERAMPORE | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||