Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04934 | Date 27/04/2019 |
| Token No | SM/19-20/1754 27/04/2019 | Serial | 003 Last Visit: 27/04/2019 |
| Patient Name | Mr. DIPENDU SHA | Contact No | 9883621855 |
| Address | 10 T.C GOSWAMI STREET SERAMPORE (M) | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||