Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06981 | Date 25/11/2019 |
| Token No | SM/19-20/13944 25/11/2019 | Serial | 053 Last Visit: 25/11/2019 |
| Patient Name | Mr. SAMPAD DAS | Contact No | 7998311655 |
| Address | 9/B DHARMATALA LANE CHATRA SERAMPORE | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||