Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05089 | Date 13/05/2019 |
| Token No | SM/19-20/3437 25/05/2019 | Serial | 063 Last Visit: 25/05/2019 |
| Patient Name | Mr. RUPAM MONDAL | Contact No | 9681052559 |
| Address | 40/2 A.P GHOSH ROAD CHATRA SERAMPORE | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||