Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04900 | Date 25/04/2019 |
| Token No | SM/19-20/1620 25/04/2019 | Serial | 006 Last Visit: 25/04/2019 |
| Patient Name | Mr. ARPAN SOM | Contact No | 9830716993 |
| Address | CHATRA DUTTAS LANE SERAMPORE | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||