Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07275 | Date 03/01/2020 |
| Token No | SM/19-20/16186 03/01/2020 | Serial | 035 Last Visit: 03/01/2020 |
| Patient Name | Mr. AMIYO DAS | Contact No | 6295920742 |
| Address | 12 CHAKRABORTY LANE SERAMPORE | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||