Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01472 | Date 03/10/2018 |
| Token No | SM/18-19/2363 03/10/2018 | Serial | 018 Last Visit: 10/10/2018 |
| Patient Name | Mr. ANURAG PALIT | Contact No | 9330800201 |
| Address | CHATRA CHOWDHURI PARA LANE | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||