Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 04076 | Date 08/03/2019 |
| Token No | SM/18-19/10112 08/03/2019 | Serial | 003 Last Visit: 08/03/2019 |
| Patient Name | Mr. RAJIT BAG | Contact No | |
| Address | PADYABATI KALANI,BAIDYABATI(M) | Age | 10 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||