Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05958 | Date 25/07/2019 |
| Token No | SM/19-20/7321 25/07/2019 | Serial | 074 Last Visit: 25/07/2019 |
| Patient Name | Master SUBHANKAR DAS | Contact No | 9737256884 |
| Address | 2 P.N CHAKRABORTY LANE CHATRA SERAMPORE | Age | 3 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||