Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06194 | Date 21/08/2019 |
| Token No | SM/19-20/8921 21/08/2019 | Serial | 083 Last Visit: 30/08/2019 |
| Patient Name | Mr. SANTANU SOM | Contact No | 9748244970 |
| Address | 123/A CHATRA BARUI PARA LANE SERAMPORE | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||