Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04587 | Date 06/04/2019 |
| Token No | SM/19-20/393 06/04/2019 | Serial | 021 Last Visit: 06/04/2019 |
| Patient Name | Mr. DEBAL BASU | Contact No | 7688016963 |
| Address | 29/J LAHIRI PARA LANE CHATRA SERAMPORE | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||