Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01064 | Date 12/09/2018 |
| Token No | SM/18-19/1541 12/09/2018 | Serial | 007 Last Visit: 12/09/2018 |
| Patient Name | Master SHIRSENDU HALDAL | Contact No | |
| Address | CHATRA KALI BABUR GHAT | Age | 4.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||