Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05235 | Date 25/05/2019 |
| Token No | SM/19-20/3440 25/05/2019 | Serial | 066 Last Visit: 13/12/2019 |
| Patient Name | Mr. SOMNATH RAJAK | Contact No | 9830595834 |
| Address | 9 CHAKRABORTY LANE SERAMPORE | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||