Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04986 | Date 30/04/2019 |
| Token No | SM/19-20/1986 30/04/2019 | Serial | 054 Last Visit: 30/04/2019 |
| Patient Name | Mr. SRIJAN RUI DAS | Contact No | 6290315698 |
| Address | 6 DR BR AMBEDKAR LANE, SERAMPORE | Age | 5.4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||