Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06727 | Date 22/10/2019 |
| Token No | SM/19-20/19579 13/03/2020 | Serial | 053 Last Visit: 13/03/2020 |
| Patient Name | Mr. INDROJIT ADHIKARY | Contact No | 7044241217 |
| Address | 21 KUMIR JELA ROAD SERAMPORE | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||