Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06174 | Date 20/08/2019 |
| Token No | SM/19-20/8808 20/08/2019 | Serial | 087 Last Visit: 20/08/2019 |
| Patient Name | Mr. BIPLANU SOM | Contact No | 9123336747 |
| Address | 123 A BARUI PARA LANE, SERAMPORE | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 78 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||