Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01250 | Date 20/09/2018 |
| Token No | SM/18-19/1883 20/09/2018 | Serial | 034 Last Visit: 20/09/2018 |
| Patient Name | Master SUJIT DAS | Contact No | |
| Address | BAIDYABATI,KHAR POLLI | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||