Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05286 | Date 29/05/2019 |
| Token No | SM/19-20/3665 29/05/2019 | Serial | 032 Last Visit: 29/05/2019 |
| Patient Name | Mr. RAJDEEP CHAKRABORTY | Contact No | 9883078020 |
| Address | 6 PN CHAKRABORTY LANE CHATRA SERAMPORE | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||