Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05442 | Date 15/06/2019 |
| Token No | SM/19-20/4620 15/06/2019 | Serial | 003 Last Visit: 22/06/2019 |
| Patient Name | Mr. SUFAL SADHUKHAN | Contact No | 9123372556 |
| Address | 40/3/A A.P GHOSH ROAD CHATRA SERAMPORE | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||