Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04450 | Date 28/03/2019 |
| Token No | SM/18-19/11476 28/03/2019 | Serial | 078 Last Visit: 28/03/2019 |
| Patient Name | Master RAJ KOYAL | Contact No | |
| Address | CHATRA PAMPA NAGAR , BAIDYABATI(M) | Age | 4.6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||