Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01968 | Date 14/11/2018 |
| Token No | SM/19-20/13710 21/11/2019 | Serial | 048 Last Visit: 21/11/2019 |
| Patient Name | Mr. ADITYA PRAMANICK | Contact No | 8272951954 |
| Address | 105A/H G.T ROAD MANIKGHOSER BAGAN CHATRA SERAMPORE | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||