Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05651 | Date 02/07/2019 |
| Token No | SM/19-20/5777 02/07/2019 | Serial | 067 Last Visit: 02/07/2019 |
| Patient Name | Mr. KAUSHAL BHADRA | Contact No | 9903482522 |
| Address | 4 CHOWDHURY PARA LANE CHATRA SERAMPORE(M) | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||