Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07276 | Date 03/01/2020 |
| Token No | SM/19-20/16194 03/01/2020 | Serial | 043 Last Visit: 03/01/2020 |
| Patient Name | Mr. ARPAN SOM | Contact No | 8013684075 |
| Address | 104 BARUI PARA LANE CHATRA SERAMPORE | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||