Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06961 | Date 23/11/2019 |
| Token No | SM/19-20/13809 23/11/2019 | Serial | 004 Last Visit: 23/11/2019 |
| Patient Name | Mr. ARIJIT BASU | Contact No | 9836059524 |
| Address | 16 CHATRA BAZAR ROAD SERAMPORE | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||