Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01951 | Date 14/11/2018 |
| Token No | SM/19-20/15137 12/12/2019 | Serial | 057 Last Visit: 12/12/2019 |
| Patient Name | Mr. KAUSTAB NAG | Contact No | 9088430965 |
| Address | 17A CHATRA BAZER ROAD SERAMPORE | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||