Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04972 | Date 29/04/2019 |
| Token No | SM/19-20/1902 29/04/2019 | Serial | 058 Last Visit: 29/04/2019 |
| Patient Name | Mr. TAMAL DUTTA | Contact No | 8482043310 |
| Address | 23 BARUI PARA LANE CHATRA SERAMPORE | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||