Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06975 | Date 23/11/2019 |
| Token No | SM/19-20/13876 23/11/2019 | Serial | 071 Last Visit: 23/11/2019 |
| Patient Name | Mr. SPANDAN GHOSH | Contact No | 9433139912 |
| Address | ASHA BARI APPARTMENT, FLAT NO-F18 DOCTOR BAGAN LANE SERAMPORE(M) | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||