Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01497 | Date 04/10/2018 |
| Token No | SM/18-19/2429 04/10/2018 | Serial | 027 Last Visit: 04/10/2018 |
| Patient Name | Mr. SUBHOM DAS | Contact No | 9831623683 |
| Address | 27 B A P GHOSH ROAD | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||