Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01423 | Date 29/09/2018 |
| Token No | SM/18-19/2251 29/09/2018 | Serial | 039 Last Visit: 29/09/2018 |
| Patient Name | Mr. SUMIT KUMAR BARI | Contact No | 8017814044 |
| Address | 5/A CHTAR CHAPA TALA LANE | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||