Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04990 | Date 30/04/2019 |
| Token No | SM/19-20/2290 07/05/2019 | Serial | 071 Last Visit: 27/02/2020 |
| Patient Name | Mr. SAMANWAYA SARKAR | Contact No | 8910232699 |
| Address | 14 THAKUR DAS BABU LANE, SERAMPORE | Age | 12 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||