Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03496 | Date 12/02/2019 |
| Token No | SM/19-20/2729 14/05/2019 | Serial | 043 Last Visit: 14/05/2019 |
| Patient Name | Mr. SUPRADIP GHOSH | Contact No | 9830414738 |
| Address | 137 A.P GHOSH ROAD | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||