Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 05448 | Date 15/06/2019 |
| Token No | SM/19-20/4653 15/06/2019 | Serial | 036 Last Visit: 28/11/2019 |
| Patient Name | Mr. NILANGSHU RUI DAS | Contact No | 6290315698 |
| Address | 16A DR BR AMBEDKAR LANE SERAMPORE | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||