Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 01269 | Date 22/09/2018 |
| Token No | SM/18-19/1929 22/09/2018 | Serial | 042 Last Visit: 26/09/2019 |
| Patient Name | Mr. BISWARUP DAS | Contact No | 8420157235 |
| Address | CHATRA MUKHARJEE PARA,BAIDAYBATI | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||