Ticket for Outdoor Patient
Ward No.  15 U-PHC No.   Registration No.  03545 Date  05/12/2019
Token No SM/19-20/7854   05/12/2019 Serial 004
Patient Name Mr. MAINAK DHAR Contact No8910720543
Address 111/B J N LAHIRI ROAD Age 11 YRS  Male
Token For Medicine, Charge Free
B.P                  mmHg Weight             KG
Pulse Rate                  / min Height             cm
Diagnosis