Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 05805 | Date 17/07/2019 |
| Token No | SM/19-20/6658 17/07/2019 | Serial | 030 Last Visit: 22/07/2019 |
| Patient Name | Mr. SOMNATH DAS | Contact No | 8697629512 |
| Address | 94/1 G. T. ROAD,MUKHERJEE BAGAN,BAIDYABATI(M) | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||