Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08422 | Date 25/06/2020 |
| Token No | SM/19-20/23389 25/06/2020 | Serial | 028 Last Visit: 25/06/2020 |
| Patient Name | Mr. SAUMYAJIT DUTTA | Contact No | 6290891871 |
| Address | 36 NO CHATRA DUTTA PARA LANE CHATRA SERAMPORE | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||