Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 00854 | Date 31/08/2018 |
| Token No | SM/18-19/1692 15/09/2018 | Serial | 012 Last Visit: 15/09/2018 |
| Patient Name | Mr. SOUVIK MAITY | Contact No | 9836595206 |
| Address | 11 MUKHERJEE PARA CHATRA,BAIDYABATI | Age | 16.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||