Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05322 | Date 03/06/2019 |
| Token No | SM/19-20/18121 15/02/2020 | Serial | 020 Last Visit: 15/02/2020 |
| Patient Name | Mr. SHYAMAL KUMAR BAGCHI | Contact No | 9836515118 |
| Address | H.M GOSWAMI STREET SERAMPORE(M) | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||