Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04980 | Date 30/04/2019 |
| Token No | SM/19-20/1974 30/04/2019 | Serial | 042 Last Visit: 30/04/2019 |
| Patient Name | Mr. AMIT KUMAR DAS | Contact No | 8335801440 |
| Address | 37/A CHATRA DHARMOTALA LANE SERAMPORE | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||