Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01305 | Date 24/09/2018 |
| Token No | SM/18-19/1993 24/09/2018 | Serial | 052 Last Visit: 24/09/2018 |
| Patient Name | Master SUMIT MONDAL | Contact No | 9123993214 |
| Address | CHATRA BAGER BAGAN | Age | 5 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||