Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04596 | Date 06/04/2019 |
| Token No | SM/19-20/13723 21/11/2019 | Serial | 061 Last Visit: 21/11/2019 |
| Patient Name | Mr. SUVOMOY DUTTA | Contact No | 9674434465 |
| Address | 80 CHATRA BARUI PARA SERAMPORE | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||