Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04327 | Date 20/03/2019 |
| Token No | SM/18-19/10973 20/03/2019 | Serial | 078 Last Visit: 27/08/2019 |
| Patient Name | Mr. AKASH SOM | Contact No | 9830679114 |
| Address | 19 CHATRA BARUI PARA SERAMPORE | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||