Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06953 | Date 22/11/2019 |
| Token No | SM/19-20/13760 22/11/2019 | Serial | 009 Last Visit: 22/11/2019 |
| Patient Name | Master DEEP MALLICK | Contact No | 7278607877 |
| Address | BYE SERAMPORE SARADAPOLLY, BAIDYABATI(M) | Age | 4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||